Laser system and method for performing and sealing corneal incisions in the eye

- LensAR, Inc.

There is provided a system, apparatus and methods for developing laser systems that can create precise predetermined self-sealing incisions in the cornea. The systems, apparatus and methods further provide laser systems that can provide these incisions in conjunction with the removal and replacement of the natural human crystalline lens.

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Description

Applicants claim, under 35 U.S.C. §119(e), the benefit of priority of the filing date of Jul. 24, 2009 of U.S. provisional patent application Ser. No. 61/228,484, filed on the aforementioned date, the entire contents of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to methods and systems for improving procedures that address cataracts, opacifications in the lens, clear lens extraction, removal of natural lens material, use of lens replacement materials and combinations of these. Specifically, the present invention relates to systems and methods that provide predetermined, precise and reproducible laser shot patterns for creating incisions in the cornea and for sealing such incisions, and which are made in predetermined and precise shapes that are reproducible from patient to patient and surgeon to surgeon.

2. Discussion of Related Art

The established treatment for cataracts is the removal of the opacified human crystalline lens and its replacement with an intraocular lens (“IOL”). In general, IOLs consist of a small plastic lens with plastic side struts, called haptics, to hold the lens in place within the capsular bag inside the eye. Exemplary types of IOLs include monofocal lenses, multifocal IOLs, which provide the patient with multiple-focused vision at far and reading distance, and accommodative IOLs, which provide the patient with visual accommodation. The flexible nature of many IOLs enables them to be rolled and/or folded up for insertion into the capsule. Examples of IOL are found in U.S. Pat. Nos. 7,188,949, 6,849,091, 5,699,142 and 5,607,472, the entire disclosures of each of which are incorporated herein by reference. Commercially available IOLs that, by way of example, may benefit from the present invention are CRYSTALENS and ACRYSOF RESTOR.

The CRYSTALENS IOL was developed by Eyeonics and is presently provided by Bausch & Lomb, and it is at least in part believed to be disclosed in U.S. Pat. No. 6,849,091. Further information regarding its structure and efficacy is provided by Food and Drug Administration (FDA) PMA P030002 and related documents to that PMA file. The FDA approved indicated use for CRYSTALENS was in part: “The Crystalens™ Model AT-45 Accommodating IOL is intended for primary implantation in the capsular bar of the eye for visual correction of apkakia in adult patients in whom a cataractous lens has been removed and is intended to provide near, intermediate, and distance vision without spectacles. The Crystalens™ IOL provides approximately one diopter of monocular accommodation.” (Nov. 14, 2003 PMA P030002 at Part 2, Summary of Safety and Effectiveness Data, ¶ INDICATIONS FOR USE).

Thus, the CRYSTALENS is an example of an FDA approved accommodating IOL. The term “FDA approved accommodating IOL” refers to any IOL that has obtained FDA approval having an indicated use that provides for accommodation, regardless of whether such IOL is actually being employed for such an approved use.

The ACRYSOF RESTOR IOL is provided by Alcon, and it is at least in part believed to be disclosed in U.S. Pat. No. 5,669,142. Further information regarding its structure and efficacy is provided by FDA PMA P040020 and related documents to that PMA file. The FDA approved use for RESTOR was in part: “AcrySOF® ReSTOR® IOLs are indicated for the visual correction of aphakia secondary to removal of a cataractous lens in adult patients with and without presbyopia, who desire near, intermediate and distance vision with increased spectacle independence. The lens is intended to be placed in the capsular bag.” (Apr. 24, 2004, PMA P040020, at Part 2, Summary of Safety and Effectiveness Data, ¶ INDICATIONS).

Thus, the RESTOR is an example of an FDA approved IOL for near, intermediate and distance vision. The term “FDA approved IOL for near, intermediate and distance vision” refers to any IOL that has obtained FDA approval having an indicated use that provides for near, intermediate and distance vision, regardless of whether such IOL is actually being employed for such an approved use. The CRYSTALENS would also be an example of an FDA approved IOL for near, intermediate and distance vision. Moreover, the RESTOR and CRYSTALENS are examples of an FDA approved IOLs that reduce and/or eliminate the need for spectacles.

The removal of the natural crystalline lens and replacement with a lens replacement material employs the use of small initial incision or incisions in the limbal area of the eye, which is the transition area between the cornea and sclera. This initial incision is typically made with a small triangular blade that is pushed into the limbal area of the eye. It is through this initial incision that other instruments for use in the removal and replacement of natural lens material are inserted and also it is through this incision that the natural lens material is removed from the eye and replacement lens material inserted into the eye.

Once the initial incision has been made the removal of the opacified natural crystalline lens and replacement with a lens replacement material, such as an FDA approved IOL, presently employs a capsulorhexis and/or a capsulotomy. A capsulorhexis generally consists of the removal of a part of the anterior lens capsule and the creation of a hole or opening in the lens capsule, that results from at least in part a tearing action. A capsulotomy generally consists of a cutting of the lens capsule, without or with minimum tearing of the capsule. Thus, to remove the opacified natural lens material, the lens capsule is opened. There are several known techniques for performing a capsulorhexis and a capsulotomy. These would include the technique known as a can opener approach, a Continuous Curvilinear Capsulorhexis (CCC) and the use of a Fugo plasma blade.

To date is it believed that all prior techniques and apparatus and in particular all prior FDA approved apparatus for creating the initial incision into the cornea of the eye have to varying degrees given rise to surgeon-to-surgeon and patient-to-patient irregularities. These irregularities have given rise to slower or less desirable wound healing and results. Moreover, it is believed that all of these prior techniques and apparatus, which are performed by hand, in general can only produce cuts or holes that are essentially simple and planar in nature. Further, because these are hand held devices the shape of these cuts may vary from patient-to-patient and surgeon-to-surgeon. Thus, it is not believed that these hand held devices and non-automated techniques can provide the precise predetermined techniques and cuts of the present invention.

SUMMARY

It is desirable to develop systems that would reduce, eliminate or correct these undesirable features, provide greater control in the creation of the incisions and make these improvements patient and surgeon independent, or at least, reduce the variability from patient-to-patient and surgeon-to-surgeon, associated with the formation of these undesirable features that is found with the use of present techniques and tools.

The novel and improved methods and systems for the performance of incisions in the sclera, limbus and cornea, which comprise aspects of the present inventions and which are set forth in detail in the present patent specification, may provide for better implementation of other methods and systems for delivering laser beams to the lens of the eye, such as those disclosed in published applications US 2007/173794A1, US 2007/173795A1, US 2007/185475A1, WO 2007/084694 A2, and WO 2007/084627A2, the entire disclosures of each of which are incorporated herein by reference.

The present invention, among other things, solves this need by providing greater control in the creation of precise and predetermined incision to the sclera, limbus and cornea. Thus, there is provided herein a system and method to perform as disclosed and claimed here in.

One of ordinary skill in the art will recognize, based on the teachings set forth in these specifications and drawings, that there are various embodiments and implementations of these teachings to practice the present invention. Accordingly, the embodiments in this summary are not meant to limit these teachings in any way.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic diagram of a first embodiment of a limbal area pattern and resultant cut in accordance with the present invention.

FIG. 2 is a schematic diagram of a second embodiment of a limbal area pattern and resultant cut in accordance with the present invention.

FIG. 3 is a schematic diagram of a third embodiment of a limbal area pattern and resultant cut in accordance with the present invention.

FIG. 4 is a schematic diagram of an embodiment of a system for delivering a laser beam to the lens of an eye in accordance with the present invention to produce the limbal area patterns and cuts shown in FIGS. 1-3.

 DESCRIPTION OF THE DRAWINGS AND THE PREFERRED EMBODIMENTS

In general, the present inventions relate to methods and systems for providing a laser to the cornea of the eye to address, improve and procedures relating to the removal of the natural crystalline lens and replacement of that lens with lens replacement material, and more specifically to improvements in systems and methods related to cataract surgery. In particular, the present inventions relate to methods and systems for providing self sealing incisions to the eye which incisions may be used as a way to insert instruments into the eye and to remove material from the eye, and to provide increased healing of these particular incisions, as well as, other types of corneal incisions.

The present methods and systems described herein can be used with the novel and innovative laser system techniques that are the subject of the co-pending patent applications that are cited herein and which have been incorporated herein by reference, and the present methods and systems may possibly be used with other laser delivery systems for the removal of lens material to the extent such systems may be developed in the future. Preferably, the present methods and systems can be incorporated into and used in conjunction with the systems of the co-pending applications that have been incorporated herein by reference. In this way a single system, with a single therapeutic laser, can function as a start to finish device for performing the cuts necessary to remove and replace the natural lens.

Novel and pioneering laser systems and methods for the removal and replace of lens material are disclosed in regular and provisional U.S. patent application Ser. No. 61/228,506; Ser. No. 61/228,529; Ser. No. 61/228,514; Ser. No. 12/509,412; and Ser. No. 12/509,211, the entire contents of each of which are incorporated herein by reference.

Thus, in general the present invention provides for a laser system, i.e., a laser device for delivering a laser to the cornea of the eye. In general, the laser system has a treatment or therapeutic laser, optics for delivering the laser beam from the treatment laser to the eye, and a particular pattern which provides for the placement of treatment laser shots in the cornea to create precise and predetermined incisions in that material, which incisions are for the purpose of inserting instruments and material into and from the eye. The patterns and resultant incisions are made in general by creating a single cut having an anterior point or opening located at or near the limbus and a posterior point or opening located at or near Descemet's membrane, which results in two sides or side pieces. It is theorized that each piece is shaped in a manner that provides for physical interaction between the pieces, creating a locking and/or tongue and groove effect. Additionally, because the incisions of the present invention have a total length that is greater than a straight incision along the same general path, i.e., from posterior opening to anterior opening, and thus have greater surface area between the two sides, it is theorized that this increased surface area promotes quicker healing. In this way after the incision is physically opened with instruments for the insertion and removal of material from the eye and in particular the natural lens of the eye, upon removal of the instrument the incision will close and the physical shape of the sides of the incision will result in the self-sealing of the incision.

Referring now to FIG. 1 there is provided an example of a self-sealing pattern and resultant incision of the present invention. Accordingly, there is shown in a schematic representation the cornea 1, the limbus 2 and sclera 3. A shot pattern 4 is provided, which when delivered to the eye results in an incision of the same shape. The incision has two sides 5 and 6. When viewed along the anterior to posterior axis of the incision, axis arrow 7, it is seen that the incision loops back on top of itself. Thus, the incision crosses its anterior to posterior axis at least twice. This would be an example of a tongue and groove type of pattern. Further, the angle of the cut with respect to the surface of the eye at the anterior point or opening of the cut resulting from pattern 4 is very shallow, i.e., it is less than 90 degrees, preferably less than about 45 degrees and more preferably less than about 30 degrees. The angle of the cut with respect to the posterior surface of the cornea, and in particular Descemet's membrane, at the posterior point or opening of the cut resulting from pattern 4 is about 90 degrees and more preferably about 75 degrees to about 105 degrees.

Referring now to FIG. 2 there is provided an example of a self-sealing pattern and resultant incision of the present invention. Accordingly, there is shown in a schematic representation the cornea 1, the limbus 2 and sclera 3. A shot pattern 8 is provided, which when delivered to the eye results in an incision of the same shape. The incision has two sides 9 and 10. When viewed along the anterior to posterior axis of the incision, axis arrow 7, it is seen that the incision loops back on top of itself. Thus the incision crosses its anterior to posterior axis at least three times. This would be an example of a tongue and groove type of pattern. If can further be seen that the side 10 has a finger section 11 extending into side 9. This finger section 11 has a narrow portion 12 and a wide portion 13. It can further be seen that the portion 13 is wider than the narrow portion 12, thus providing added locking force to this tongue and groove configuration.

Referring now to FIG. 3 there is provided an example of a self-sealing pattern and resultant incision of the present invention. Accordingly, there is shown in a schematic representation the cornea 1, the limbus 2 and sclera 3. A shot pattern 14 is provided, which when delivered to the eye results in an incision of the same shape. The shot pattern has an anterior start point 19 and a posterior end point 20, which is located in Descemet's membrane. The length of the incision is substantially greater than the length of a straight line drawn between points 19 and 20. The use of the terms “start” and “end” are solely for special identification purposes and are not intend to require that the cut be made from the anterior to the posterior. The incision has two sides 15 and 16. When viewed along the anterior to posterior axis of the incision, axis arrow 7, it is seen that the incision loops back on top of itself. Thus the incision crosses its anterior to posterior axis at least three times. This would be an example of a tongue and groove type of pattern. If can further be seen that side 15 has finger section 17 and side 16 has finger section 18 and 16 have finger section 11 extending into side 9. Unlike finger section 11, finger sections 17, 18 do not have narrow and wide portions.

In general a preferred laser system, i.e., a laser device, for treating patients is provided as shown by way of example in FIG. 4. In this system there is provided a treatment laser 101; optics 102 for delivering the laser beam 104; a control system 103 for delivering the laser beam to the lens in a particular pattern, which control system 103 is associated with and/or interfaces with the other components of the system, as shown for example by dashed lines in FIG. 4, and/or other control systems not shown in FIG. 4.

In general, a laser system for providing the pattern and creating the resultant cuts in the cornea has by way of example and referring to FIG. 4 a treatment laser 101 which should provide a beam 104. The beam should be of a short pulse width, together with the energy and beam size, to produce photodisruption. Thus, as used herein, the term laser shot or shot refers to a laser beam pulse delivered to a location that results in photodisruption. As used herein, the term photodisruption essentially refers to the conversion of matter to a gas by the laser. The term photodisruption has also been generally referred to as Laser Induced Optical Breakdown (LIOB). In particular, wavelengths of about 300 nm to 2500 nm may be employed. Pulse widths from about 1 femtosecond to 100 picoseconds may be employed. Energies from about a 1 nanojoule to 1 millijoule may be employed. The pulse rate (also referred to as pulse repetition frequency (PRF) and pulses per second measured in Hertz) may be from about 1 KHz to several GHz. Generally, lower pulse rates correspond to higher pulse energy in commercial laser devices. A wide variety of laser types may be used to cause photodisruption of ocular tissues, dependent upon pulse width and energy density. Thus, examples of such lasers are disclosed in U.S. Patent Application Publication No. 2007/084694 A2 and WO 2007/084627A2, the entire contents of each of which are incorporated herein by reference. These and other similar lasers may be used a therapeutic lasers. For procedures on the cornea, limbus and area where the cornea and sclera join the same type of therapeutic laser as described herein may be used, with the energy and focal point being selected to perform the desired procedure.

In general, the optics 102 for delivering the laser beam 104 to the structures of the eye including the cornea and the natural lens of the eye should be capable of providing a series of shots in a precise and predetermined pattern in the x, y and z dimension. The z dimension as used herein refers to that dimension which has an axis that corresponds to, or is essentially parallel with the A-P axis of the eye. The optics should also provide a predetermined beam spot size to cause photodisruption with the laser energy reaching the structure of the eye intended to be cut.

In general, the control system 103 for delivering the laser beam 104 may be any computer, controller, and/or software hardware combination that is capable of selecting and controlling x-y-z scanning parameters and laser firing. These components may typically be associated at least in part with circuit boards that interface to the x-y scanner, the z focusing device and/or the laser. The control system may also, but does not necessarily, have the further capabilities of controlling the other components of the system, as well as, maintaining data, obtaining data and performing calculations. Thus, the control system may contain the programs that direct the laser through one or more laser shot patterns. Similarly, the control system may be capable of processing data from the slit scanned laser and/or from a separate controller for the slit scanned laser system.

The laser optics 102 for delivering the laser beam 104 includes a beam expander telescope 105, a z focus mechanism 106, a beam combiner 107, an x-y scanner 108, and focusing optics 109. There is further provided relay optics 110, camera optics 111, which include a zoom, and a first ccd camera 112.

Optical images 113 of the eye 114 and in particular optical images of the natural lens 115 of the eye 114 are conveyed along a path 113. This path 113 follows the same path as the laser beam 104 from the natural lens 115 through the laser patient interface 116, the focusing optics 109, the x-y scanner 108 and the beam combiner 107. There is further provided a laser patient interface 116, and a structured light source 117 and a structured light camera 118, including a lens. Examples of patient interface and related apparatus that are useful with the present system are provided in provisional and regular U.S. patent application Ser. No. 12/509,021, and Ser. No. 61/228,457, wherein the entire disclosures of each of which are incorporated herein by reference.

The structured light source 117 may be a slit illumination having focusing and structured light projection optics, such as a Schafter+Kirchhoff Laser Macro Line Generator Model 13LTM+90CM, (Type 13LTM-250S-41+90CM-M60-780-5-Y03-C-6) or a StockerYale Model SNF-501 L-660-20-5, which is also referred to as a slit scanned laser. In this embodiment the structured illumination source 117 also includes slit scanning means 119.

When using a scanned slit illumination the operation includes positioning the slit on one side of the lens, taking an image then moving the slit approximately one slit width, then taking another image, and then repeating this sequence until the entire lens is observed. For example, a 100 μm slit width can scan a nominal 9 mm dilated pupil diameter in 90 images, which takes approximately 3 seconds using a 30 Hz frame rate camera. To obtain images of the anterior surface in a single image without overlap, the slit should be at an angle to the AP axis, i.e., it should not be parallel to that axis. The nominal slit angle can be approximately 15 to 30 degrees from the AP axis. Any visible or near IR wavelength source within the sensitivity of the camera may be used. Low coherence length sources are preferable to reduce speckle noise.

The structured light illumination source 117 and the structured light camera 118 are arranged in an angled relationship. The angled relationship may be but is not required to be in the so-called Scheimpflug configuration, which is well-known. The structured light source 117, in conjunction with the slit scanning means 119, projects a line and or a plurality of lines onto the eye lens 115 at an angle or plurality of angles. The light scattered at the eye lens 115 forms the object to be imaged by the lens and focused onto the camera system 118. Since the slit illuminated image in the eye lens 115 may be at a large angle with respect to the camera 118, this presents a large depth of field to the camera and the entire slit image may not be in sharp focus at the camera. By tilting the camera at an angle or plurality of angles the image along the illuminated plane can be in sharper focus. To the extent that a sharper focus is not obtained, arithmetic data evaluation means are further provided herein to determine a more precise location of the illuminated structures with respect to the laser device.

The images from the camera 118 may be conveyed to the controller 103 for processing and further use in the operation of the system. They may also be sent to a separate processor and/or controller, which in turn communicates with the controller 103. The structured light source 117, the camera 118 and the slit scanning means 119 includes a means for determining the position and apex of the lens in relation to the laser system.

The delivery of laser shot patterns and cuts per FIGS. 1-3 for the removal of lens material is provided. Thus, there are provided methods and systems for producing cuts, i.e., incisions in the anterior lens capsule. These cuts are created by the therapeutic laser beam 104 being delivered to the anterior lens capsule in precise predetermined and highly reproducible patterns, delivery results in precise predetermined and highly reproducible shaped cuts in patterns as described and taught herein, or as may be called for by the use of a particular IOL or other device or material to be inserted within the lens capsule. As used herein geometric shaped patterns or cuts referrer to circular and elliptical shaped patterns or cuts. As used herein non-geometric shaped patterns or cuts refers to all other shapes that are not circular or elliptical.

The methods and systems to create these cuts in the anterior capsule provide superior results to the handheld methods and apparatus previously known for performing capsulorhexus and capsulotomy, and thus, the methods and systems disclosed herein are considered to be a substantial advancement in these techniques. In addition the delivery of the laser beam shots in a manner that greatly reduces the risk of a missed cut, which depending upon the particular application may be very significant is provided. Moreover, as provided in the following examples, anterior capsule cuts are envisioned and provided that may be a continuous cuts, cuts and lands (uncut capsule portions between cuts) and perforations. Thus, as used herein the terms “missed cut” or “missed cuts” refer to a cut that was intended to be carried out by the delivery of a particular laser shot pattern, but which did not occur because the laser beam missed the lens capsule or targeted lens material. Thus, in a cut and land pattern the lands would not be considered missed cuts, if they were intended to be left uncut by the laser pattern.

The cuts in the lens anterior surface are for the purpose of creating an opening in the lens capsule for the remove of the interior structures of the lens. To facilitate this removal there are provided various laser shot patterns that cut the interior structure of the lens into small volumes, which volumes can then be removed from the lens capsule. These small volumes can range from about 1 mm2 to about 16 mm2 and more preferably from about 2.5 mm2 to about 4 mm2. Thus a grid laser shot pattern within the interior structures of the lens, which creates cube shaped volumes of interior lens material, can be employed. These cubes can range in size from a side having a length of about 100 μm to about 4 mm, with about 500 μm to 2 mm being a preferred size. Additionally, this invention is not limited to the formation of cubes and other volumetric shapes of similar general size may be employed. For example arrangement of other shapes such as triangles and pie sliced volumes may be employed.

The laser cut in the anterior capsule is used to create a small opening in the lens anterior surface of the lens capsule for removal of the sectioned volumes of interior material. Thus, this procedure may be used to treat cataracts. This procedure may also be used to remove a lens having opacification that has not progressed to the point of being cataractous. This procedure may further be used to remove a natural lens that is clear, but which has lost its ability to accommodate. In all of the above scenarios, it being understood that upon removal of the lens material the lens capsule would subsequently house a suitable replacement, such as an IOL, accommodative IOL, or synthetic lens refilling materials. Moreover, the size and the shape of the opening is variable and precisely controlled and preferably for presently know lens refilling materials and IOLs is 2 mm or less diameter for lens refilling applications and about 5 mm for IOLs.

The order in which these activities are performed may depend upon the particular characteristics of the internal lens structure, the density of the cataract, the position of the cataract, the type of device used to remove the internal lens material once it has been sectioned into small volumes, the type and power of the laser used, the amount and size of gas bubbles that are produced by the laser, and other factors. Thus, although the examples herein provide for an order of performing the activity of cutting the anterior surface of the lens and sectioning the interior structures of the lens, it should be recognized that this order can be changed, as well as, performed essentially simultaneously or simultaneously.

The preferred laser system for treating patients is capable of making precise and predetermined cuts in the capsule of the lens thus giving rise to capsulotomies that are of precise and predetermined shapes. Thus, there is provided the method of obtaining and analyzing the shape and structure of an IOL, and in particular obtaining and analyzing the shape and structure of an accommodating IOL, an IOL that reduces and/or eliminates the need for spectacles, and/or an IOL for near, intermediate and distance vision, including but limited to FDA approved versions of the IOLs. Based upon this analysis an optimized shape and position for the capsulotomy for use with a particular IOL, or grouping of similarly shaped IOLs, is determined. A predetermined shot pattern for making this optimized shaped capsulotomy is then provided to the laser system, preferably by providing the shot pattern to the control system 103. The laser system can then be used for an one or all of the following procedures, determining the shape and position of the anterior surface of the lens, and in particular the anterior surface of the lens capsule, determining the apex of the lens capsule in relation to the laser system, performing a laser capsulotomy having the precise and predetermined shape selected for a particular type of IOL, and removal of the natural lens material.

Thus, there is provided techniques, systems and apparatus to deliver laser beam in a shot pattern to the lens of the eye and in particular to the capsule of the lens of the eye in a precise and predetermined manner to provided for a precise predetermined capsulotomy. The shape of these patterns may be delivered using either the jigsaw or ring delivery sequences.

When performing laser assisted cataract surgery the process of cutting the nucleus with a photodisruption laser can cause a buildup of gas bubbles sufficiently near the soft cortex to allow the gas bubbles to propagate toward the capsule. In those situations where bubbles collect in close proximity to the anterior capsule, when the laser attempts to cut the capsulotomy, the sudden release of bubbles my change the position of the anterior capsule during the delivery of the laser shot pattern causing the laser to miss the capsule resulting in missed cuts, at least partially around the circumference of the capsulotomy. To solve this problem, there is provided herein a special cutting pattern that is less dependent of capsule position versus time and provides cutting of the capsule despite position changes of the capsule during the laser capsulotomy procedure. Thus, resulting in substantially reduced or no missed cuts.

There is further provided herein the use of laser shot patterns having a large range of Z swept at a high rate of speed, while the X-Y position is moved in a circular, or elliptical or other pattern or desired shape, more slowly so that the laser cutting action occurs multiple times over essentially the same X-Y position. Thus, it could be envisioned that the laser beam is operating like the tip of a jigsaw blade moving up and down rapidly compared to the X-Y positioning to create the cut shape. In this way, if the anterior capsule shifts during the cut, due to gas bubble propagation or any other reason, the cut will still be made to the capsule, albeit perhaps outside the center region of the z direction up-down distribution of shots, and more to the anterior or posterior ends of that distribution. For laser cutting of the nucleus where a great deal of bubble buildup is created, a Z range, or up-down range of the cut should be approximately 1 mm in extent, nominally centered on the anterior capsule which would allow approximately +/−475 μm of capsule movement and still provide cutting of a 25 μm thick capsule.

In addition to enabling cutting of a capsule that moves during the procedure, this procedure can be used to compensate for static errors in capsule position due to for example measurement errors. In this way the extent of the Z range may be increased by the known error of the system.

In addition to the large Z range sweeps disclosed herein, there is also contemplated the use of a smaller Z range of cut motion for the case where the uncertainty in capsule position from both static measurement error and anticipated change in position might be smaller, perhaps in the range of hundreds of μm or in the case of highly precise measurement data and near zero movement of the capsule during surgery. In such a case the Z range could be tens of μm—enough range to cut through the capsule thickness.

Further methods and systems to define a high accuracy position measurement of structures of the eye and in particular the anterior capsule, so as to provide in general greater accuracy, precisions and reproducibility from patient to patient for procedures on the eye and in particular capsulotomies, is provided in regular U.S. patent application Ser. No. 12/509,412, wherein, the entire disclosure of which is incorporated herein by reference.

In the laser shot patterns provided herein it is preferred that the placement of individual shots with respect to adjacent shots in the pattern are sufficiently close enough to each other, such that when the pattern is complete a sufficiently continuous layer and/or line and/or volume of material has been removed. Shot spacing of lesser or greater distances are contemplated herein and including overlap as necessary to obtain the desired results. Shot spacing considerations include gas bubble dissipation, volume removal efficiency, sequencing efficiency, scanner performance, and cleaving efficiency among others. For example, by way of illustration, for a 5 μm size spot with an energy sufficient to cause photodisruption, a spacing of 20 μm or greater results in individual gas bubbles, which are not coalesced and dissipate more quickly, than with close shot spaces with the same energy, which result in gas bubble coalescence. As the shot spacing gets closer together volume efficiency increases. As shot spacing gets closer together bubble coalescence also increases. Further, there comes a point where the shot spacing becomes so close that volume efficiency dramatically decreases. Moreover, the forgoing shot spacing considerations are interrelated to a lesser or greater extent and one of skill in the art will know how to evaluate these conditions based upon the teachings of the present disclosure to accomplish the objectives herein. Finally, it is contemplated that the placement of individual shots with respect to adjacent shots in the pattern may in general be such that they are as close as possible, typically limited by the size and time frame of photodisruption physics, which would include among other things gas bubble expansion of the previous shot. As used herein, the time frame of photodisruptive physics referrers to the effects that take place surrounding photodisruption, such as plasma formation and expansion, shock wave propagation, and gas bubble expansion and contraction. Thus, the timing of sequential pulses such that they are timed faster than some of, elements of, or all of those effects, can increase volumetric removal and/or cleaving efficiency. Accordingly, it is proposed to use pulse repetition frequencies from 50 MHz to 5 GHz, which could be accomplished by a laser with the following parameters: a mode lock laser of cavity length from 3 meters to 3 cm. Such high PRF lasers can more easily produce multiple pulses overlapping a location allowing for a lower energy per pulse to achieve photodisruption.

The terms first, second, third, etc. as used herein are relative terms and must be viewed in the context in which they are used. They do not relate to timing, unless specifically referred to as such. Thus, a first cut may be made after a second cut. In general, it is preferred to fire laser shots in general from posterior points in the laser pattern to anterior points, to avoid and/or minimize the effect of the gas bubbles resulting from prior laser shots. However, because of the varied laser shot patterns that are provided herein, it is not a requirement that a strict posterior to anterior shot sequence be followed. Moreover, in the case of cataracts it may be advantageous to shoot from anterior to posterior, because of the inability of the laser to penetrate substantially beyond the cataract.

An additional benefit from this type of laser system may be obtained. Shots or pulses from this laser can be distributed throughout the cornea in a plane or series of planes that are perpendicular to the A-P axis of the eye. These planes will cause a wound healing effect, creating myacin. Additionally, the creation of myacin will cause a cross linking of the cornea collagen which will have the tendency to shrink the area treated with the plane of shots, which in turn tends to flatten the curvature of the cornea providing the added benefit of correcting low levels of myopia.

From the foregoing description, one skilled in the art can readily ascertain the essential characteristics of this invention, and without departing from the spirit and scope thereof, can make various changes and/or modifications of the invention to adapt it to various usages and conditions.

Claims

1. A system for performing cataract surgery on a living eye by providing laser shot patterns to the living eye, to replace a surgeon mechanical cut and reduce surgeon-to-surgeon variability, the system comprising:

a) a therapeutic laser for producing a laser beam; and
b) optics for receiving the laser beam and directing the laser beam to a living eye so that: (i) a laser shot pattern for performing a capsulotomy is generated in the living eye; (ii) a laser shot pattern for sectioning a lens of the living eye is generated in the living eye; and, (iii) a laser shot pattern for providing an incision in a cornea of the living eye for the insertion of an instrument into the living eye, the removal of lens material from the living eye and the insertion of replacement lens material into the living eye, is generated in the living eye; the incision having a cross sectional length and facing surfaces, whereby upon completion of the insertion and removal of the instrument or the lens material the facing surfaces contact each other; the incision having an anterior start point and a posterior end point; the cross sectional length of the incision being greater than a distance between the anterior start point and the posterior end point; and wherein an angle of the incision in the cornea of the eye at the anterior start point with respect to an anterior surface of the cornea of the eye is shallow.

2. The system of claim 1 wherein the laser shot pattern for providing an incision in the cornea of the eye is a tongue and groove pattern.

3. The system of claim 1 wherein the laser shot pattern for providing an incision in the cornea of the eye is a locking tongue and groove pattern.

4. The system of claim 1 wherein the laser shot pattern for providing an incision in the cornea of the eye comprises an anterior posterior axis and crosses the anterior posterior axis at least twice.

5. The system of claim 1 wherein the laser shot pattern for providing an incision in the cornea of the eye corneal pattern comprises an anterior posterior axis and crosses the anterior posterior axis at least three times.

6. The system of claim 1 wherein the posterior end point is in Descemet's membrane of the eye.

7. The system of claim 1 wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is about 90 degrees.

8. The system of claim 7, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 90 degrees.

9. The system of claim 7, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 45 degrees.

10. The system of claim 7, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is less than about 30 degrees.

11. The system of claim 1, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is from about 75 degrees to about 105 degrees.

12. The system of claim 1, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is about 90 degrees.

13. The system of claim 7, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is from about 75 degrees to about 105 degrees.

14. The system of claim 1, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

15. The system of claim 7, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

16. The system of claim 8, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

17. The system of claim 9, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

18. A system for providing a laser beam shot pattern to a living eye, the system comprising:

a) a therapeutic laser for providing a laser beam;
b) a controller in communication with the laser and controlling the laser beam so that a shot pattern is generated on a living eye;
c) the shot pattern comprising: a pattern for providing an incision in a cornea of the eye, for insertion of an instrument into the living eye, removal of lens material from the living eye and insertion of replacement lens material into the living eye; the incision having a cross sectional length and facing surfaces, whereby upon completion of an insertion and removal of the instrument or lens material at least a portion of the facing surfaces substantially contact each other; the incision having an anterior start point and a posterior end point, the posterior end point positioned in Descemet's membrane of the living eye and the cross sectional length of the incision being greater than a distance between the anterior start point and the posterior end point; the anterior starting point being positioned a greater distance from an anterior posterior axis of the incision than the posterior end point.

19. The system of claim 18, wherein an angle of the incision in the cornea of the eye at the anterior start point with respect to an anterior surface of the cornea of the eye is shallow.

20. The system of claim 19, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is about 90 degrees or less.

21. The system of claim 19, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 90 degrees.

22. The system of claim 19, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 45 degrees.

23. The system of claim 19, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 30 degrees.

24. The system of claim 18, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is about 90 degrees.

25. The system of claim 18, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is from about 75 degrees to about 105 degrees.

26. The system of claim 19, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is about 90 degrees.

27. The system of claim 20, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is from about 75 degrees to about 105 degrees.

28. The system of claim 21, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is about 90 degrees.

29. The system of claim 21, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is from about 75 degrees to about 105 degrees.

30. The system of claim 18, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

31. The system of claim 20, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

32. The system of claim 21, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

33. The system of claim 22, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

34. The system of claim 24, wherein the portion of the cross sectional length that essentially follows the shape of the cornea has a length that is less than half of the distance between the anterior starting point and the posterior end point from the anterior posterior axis of the incision.

35. The system of claim 34, wherein an angle of the incision in the cornea of the eye at the anterior start point with respect to an anterior surface of the cornea of the eye is shallow.

36. The system of claim 35, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is about 90 degrees or less.

37. A system for providing a laser beam shot pattern to an eye, the system comprising:

a) a laser for providing a laser beam;
b) a controller in communication with the laser and controlling the laser beam so that a shot pattern is generated on an eye;
c) the shot pattern comprising: i. a pattern for providing an incision in a cornea of the eye, for an insertion or removal of an item from a lens of the eye; ii. the incision having a cross sectional length and facing surfaces, whereby upon completion of the insertion or removal at least a portion of the facing surfaces substantially close; iii. the incision having an anterior start point and a posterior end point positioned in Descemet's membrane of the living eye; iv. the cross sectional length of the incision being greater than a distance between the anterior start point and the posterior end point positioned in Descemet's membrane of the living eye; v. the anterior starting point being positioned at greater distance from an anterior posterior axis of the incision than the posterior end point; and, vi. the cross sectional length having a portion that essentially follows a shape of the cornea.

38. The system of claim 37, wherein the portion of the cross sectional length that essentially follows the shape of the cornea has a length that is less than the distance between the anterior starting point and the posterior end point from the anterior posterior axis of the incision.

39. The system of claim 37, wherein an angle of the incision in the cornea of the eye at the anterior start point with respect to an anterior surface of the cornea of the eye is shallow.

40. The system of claim 39, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is about 90 degrees.

41. The system of claim 39, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 90 degrees.

42. The system of claim 39, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 45 degrees.

43. The system of claim 39, wherein the angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is less than about 30 degrees.

44. The system of claim 38, wherein an angle of the incision in the cornea of the eye at the anterior start point with respect to an anterior surface of the cornea of the eye is shallow.

45. The system of claim 44, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is about 90 degrees or less.

46. A system for providing a self-sealing incision to a living eye, the system comprising:

a) a laser for providing a laser beam;
a controller in communication with the laser and controlling the laser beam so that a shot pattern is generated on a living eye, wherein the shot pattern comprises a pattern for providing a self-sealing incision in a cornea of the eye, the self-sealing incision having an anterior start point and a posterior end point; the incision having a cross sectional length; the cross sectional length of the incision being greater than a distance between the anterior start point and the posterior end point; the anterior starting point being positioned a greater distance from an anterior posterior axis of the self-sealing incision than the posterior end point; and, the cross sectional length having a portion that essentially follows the shape of the cornea.

47. The system of claim 46 wherein the pattern for providing a self-sealing incision is a tongue and groove pattern.

48. The system of claim 46 wherein the pattern for providing a self-sealing incision is a locking tongue and groove pattern.

49. The system of claim 46 wherein the pattern for providing a self-sealing incision crosses the anterior posterior axis at least twice.

50. The system of claim 46 wherein the pattern for providing a self-sealing incision crosses the anterior posterior axis at least three times.

51. A method for performing cataract surgery stimulating corneal wound healing, using a laser system, the method comprising:

positioning an eye of a patient with respect to a laser system;
directing the laser system to create an incision in a cornea of the eye having an anterior start point and a posterior end point positioned in Descemet's membrane of the eye;
directing the laser system to perform a capsulotomy on the eye; and
directing the laser system to deliver a planar shot pattern to an area of the incision in the cornea of the eye, thereby promoting wound healing.

52. The system of claim 51, wherein the corneal incision is outside of the optically active area of the cornea above the capsulotomy.

53. A method for performing cataract surgery stimulating corneal wound healing, using a laser system, the method comprising:

positioning an eye of a patient with respect to a laser system;
creating an incision through a cornea of the eye having an anterior start point and a posterior end point in Descemet's membrane of the eye;
directing the laser system to perform a capsulotomy on the eye; and
directing the laser system to deliver a planar planer shot pattern to an area of the incision of the eye, thereby promoting wound healing.

54. The system of claim 53, wherein the corneal incision is outside of the optically active area of the cornea above the capsulotomy.

55. A system for providing a sealable opening in a cornea of a living eye for performing cataract surgery, the opening being defined by a laser formed incision, the system comprising:

a) a laser for providing a therapeutic laser beam;
b) an optics assembly for directing the laser beam;
c) a controller in communication with the laser, the optics assembly and controlling the laser beam so that a shot pattern is generated at the cornea of the eye; wherein the shot pattern comprises: i. a pattern for providing an incision in the cornea of the eye; ii. the incision having an anterior start point and a posterior end point; iii. the incision having a cross sectional length; iv. the cross sectional length of the incision being greater than a distance between the anterior start point and the posterior end point; v. the anterior starting point being positioned a different distance from an anterior posterior axis of the incision than the posterior end point; and, vi. the cross sectional length of the incisions having a portion that essentially follows the shape of the cornea.

56. The system of claim 55, wherein the portion of the cross sectional length that essentially follows the shape of the cornea is less than the difference in the distance between the anterior starting point and the posterior end point from the anterior posterior axis of the incision.

57. The system of claim 55, wherein the portion of the cross sectional length that essentially follows the shape of the cornea is less than half of the difference in the distance between the anterior starting point and the posterior end point from the anterior posterior axis of the incision.

58. The system of claim 56, wherein an angle of the incision in the cornea of the eye at the anterior start point with respect to an anterior surface of the cornea of the eye is shallow.

59. The system of claim 58, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is about 90 degrees or less.

60. The system of claim 58, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 45 degrees.

61. The system of claim 58, wherein the angle of the incision in the cornea of the eye at the anterior start point with respect to the anterior surface of the cornea of the eye is less than about 30 degrees.

62. The system of claim 56, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is about 90 degrees.

63. The system of claim 56, wherein an angle of the incision in the cornea of the eye at the posterior end point with respect to a posterior surface of the cornea of the eye is from about 75 degrees to about 105 degrees.

64. The system of claim 55, wherein the incision has a width and facing surfaces, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive an insertion of an instrument into the eye, a removal of lens material from the eye and an insertion of replacement lens material into the eye.

65. The system of claim 55, wherein the incision has a width and facing surfaces, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive an insertion of an instrument into the eye.

66. The system of claim 55, wherein the incision has a width and facing surfaces, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive an insertion of an instrument into the eye, a removal of lens material from the eye and an insertion of replacement lens material into the eye.

67. The system of claim 59, wherein the incision has a width and facing surfaces, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive an insertion of an instrument into the eye, a removal of lens material from the eye and an insertion of replacement lens material into the eye.

68. The system of claim 59, wherein the incision has a width and facing surfaces, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive an insertion of an instrument into the eye.

69. A system for performing cataract surgery on a living eye by providing laser shot patterns to the eye, to replace a surgeon mechanical cut and reduce surgeon-to-surgeon variability, the system comprising: a therapeutic laser for producing a laser beam; and optics for receiving the laser beam and directing the laser beam to the eye in a plurality of laser shot patterns, the plurality of laser shot patterns comprising:

a) a laser shot pattern for performing a capsulotomy;
b) a laser shot pattern for sectioning a lens of the eye; and,
c) a laser shot pattern for providing an incision in a cornea of the eye for an insertion and removal of an instrument into the eye; the incision having a cross sectional length and facing surfaces, whereby upon completion of an insertion and removal of an instrument the facing surfaces substantially contact each other; the incision having an anterior start point and a posterior end point; the cross sectional length of the incision being greater than a distance between the anterior start point and the posterior end point; the incision having an anterior posterior axis, wherein the anterior start point and posterior end point are on opposite sides of the anterior posterior axis.

70. The system of claim 69, wherein the incisions comprises a first portion, a second portion and a third portion, the first portion being substantially parallel to the anterior posterior axis, the second portion substantially following the shape of the cornea, and the third portion angled toward a surface of the cornea.

71. The system of claim 69, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of the instrument into the eye, a removal of lens material from the eye and an insertion of replacement lens material into the eye.

72. The system of claim 70, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of the instrument into the eye.

73. The system of claim 70, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of the instrument into the eye, a removal of lens material from the eye and an insertion of replacement lens material into the eye.

74. A system for providing a laser beam shot pattern to a living eye, the system comprising:

a) a laser for providing a laser beam;
b) a controller in communication with the laser and controlling the laser beam so that a shot pattern is generated at the eye;
c) the shot pattern comprising: a pattern for providing an incision in a cornea of the eye, for the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye; the incision having a cross sectional length and facing surfaces, whereby upon completion of an insertion and removal of instruments or material the facing surfaces substantially contact each other; the incision having an anterior start point and a posterior end point, the posterior end point positioned in Descemet's membrane of the eye and the cross sectional length of the incision being greater than a distance between the anterior start point and the posterior end point; the anterior starting point being positioned a greater distance from an anterior posterior axis of the incision than the posterior end point, wherein at least the anterior start point or the posterior end point are not on the anterior posterior axis.

75. The system of claim 74, wherein the incision comprises a first portion, a second portion and a third portion, the first portion being substantially parallel to the anterior posterior axis, the second portion substantially following a shape of the cornea, and the third portion angled toward a surface of the cornea.

76. The system of claim 74, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

77. The system of claim 75, wherein the incision has a width, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive the insertion of instruments into the eye, the removal of lens material from the eye and the insertion of replacement lens material into the eye.

78. A system for providing a sealable opening in a cornea of a living eye for performing cataract surgery, the opening being defined by a laser formed incision, the system comprising:

a) a laser for providing a therapeutic laser beam;
b) a controller in communication with the laser and controlling the laser beam so that a shot pattern is generated at the cornea of the eye; wherein the shot pattern comprises: i. a pattern for providing an incision in the cornea of the eye; ii. the incision having an anterior point and a posterior point; iii. the incision having a cross sectional length; iv. the cross sectional length of the incision being greater than a distance between the anterior point and the posterior point; v. the anterior point and the end point being positioned different distances from an anterior posterior axis of the incision; vi. the cross sectional length of the incisions having a portion that essentially follows the shape of the cornea; and, vii. wherein the incision comprises a first portion, a second portion and a third portion, the first portion being substantially parallel to the anterior posterior axis, the second portion substantially following a shape of the cornea, and the third portion angled toward a surface of the cornea.

79. The system of claim 78, wherein the incision has a width and facing surfaces, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive an insertion of an instrument into the eye, a removal of lens material from the eye and an insertion of replacement lens material into the eye.

80. The system of claim 78, wherein the incision has a width and facing surfaces, and wherein the width and facing surfaces are sized to define an openable and sealable channel in the cornea to receive a removal of lens material from the eye.

Referenced Cited
U.S. Patent Documents
3074407 January 1963 Moon et al.
3971382 July 27, 1976 Krasnov
3982541 September 28, 1976 L'Esperance, Jr.
4024852 May 24, 1977 L'Esperance et al.
4263893 April 28, 1981 Pavlak et al.
4306546 December 22, 1981 Heine et al.
4309998 January 12, 1982 Aron nee Rosa et al.
4334736 June 15, 1982 Herbert
4381007 April 26, 1983 Doss
4394144 July 19, 1983 Aoki
4403841 September 13, 1983 Lang et al.
4461294 July 24, 1984 Baron
4477159 October 16, 1984 Mizuno et al.
4502816 March 5, 1985 Creter, Jr. et al.
4517980 May 21, 1985 Tagnon
4537193 August 27, 1985 Tanner
4538608 September 3, 1985 L'Esperance, Jr.
4554917 November 26, 1985 Tagnon
4561436 December 31, 1985 Munnerlyn
4565197 January 21, 1986 Daly
4573778 March 4, 1986 Shapiro
4576160 March 18, 1986 Tanaka
4579430 April 1, 1986 Bille
4580559 April 8, 1986 L'Esperance
4582405 April 15, 1986 Muller et al.
4583539 April 22, 1986 Karlin et al.
4588505 May 13, 1986 Walley et al.
4601037 July 15, 1986 McDonald
4601288 July 22, 1986 Myers
4607622 August 26, 1986 Fritch et al.
4628416 December 9, 1986 Dewey
4633866 January 6, 1987 Peyman et al.
4638801 January 27, 1987 Daly et al.
4644948 February 24, 1987 Lang et al.
4648400 March 10, 1987 Schneider et al.
4657013 April 14, 1987 Hoerenz et al.
4665913 May 19, 1987 L'Esperance, Jr.
4669466 June 2, 1987 L'Esperance, Jr.
4669839 June 2, 1987 Muchel
4682595 July 28, 1987 Hoerenz et al.
4686979 August 18, 1987 Gruen et al.
4686992 August 18, 1987 Dewey et al.
4702245 October 27, 1987 Schroder et al.
4702576 October 27, 1987 Magnante
4711540 December 8, 1987 Yoshino et al.
4711541 December 8, 1987 Yoshino et al.
4712543 December 15, 1987 Baron
4715703 December 29, 1987 Cornsweet et al.
4718418 January 12, 1988 L'Esperance, Jr.
4719912 January 19, 1988 Wienberg
4721379 January 26, 1988 L'Esperance
4724522 February 9, 1988 Belgorod
4729372 March 8, 1988 L'Esperance, Jr.
4729373 March 8, 1988 Peyman
4732148 March 22, 1988 L'Esperance, Jr.
4732460 March 22, 1988 Kele et al.
4736744 April 12, 1988 Koike et al.
4741612 May 3, 1988 Birngruber et al.
4744362 May 17, 1988 Gründler
4758081 July 19, 1988 Barnes
4765336 August 23, 1988 Blaha et al.
4770162 September 13, 1988 L'Esperance et al.
4770172 September 13, 1988 L'Esperance, Jr.
4770486 September 13, 1988 Wang et al.
4772116 September 20, 1988 Schroder et al.
4773414 September 27, 1988 L'Esperance, Jr.
4775361 October 4, 1988 Jacques et al.
4776687 October 11, 1988 Nakanishi et al.
4798204 January 17, 1989 L'Esperance, Jr.
4820264 April 11, 1989 Matsui et al.
4830483 May 16, 1989 Kohayakawa et al.
4832043 May 23, 1989 Ichihashi
4837857 June 6, 1989 Scheller et al.
4838266 June 13, 1989 Koziol et al.
4840175 June 20, 1989 Peyman
4846172 July 11, 1989 Berlin
4848340 July 18, 1989 Bille et al.
4854693 August 8, 1989 Ichihashi et al.
4856513 August 15, 1989 Muller
4862888 September 5, 1989 Yessik
4863261 September 5, 1989 Flammer
4865029 September 12, 1989 Pankratov
4865441 September 12, 1989 Reis
4866243 September 12, 1989 Sakane et al.
4870952 October 3, 1989 Martinez
4881808 November 21, 1989 Bille et al.
4883351 November 28, 1989 Weiss
4884884 December 5, 1989 Reis
4887019 December 12, 1989 Reis et al.
4887592 December 19, 1989 Loertscher
4891043 January 2, 1990 Zeimer et al.
4900143 February 13, 1990 Bessler et al.
4900145 February 13, 1990 Akiyama
4901718 February 20, 1990 Bille et al.
4902124 February 20, 1990 Roy, Sr. et al.
4903695 February 27, 1990 Warner et al.
4905711 March 6, 1990 Bennett et al.
4907586 March 13, 1990 Bille et al.
4911160 March 27, 1990 Thyzel
4911711 March 27, 1990 Telfair et al.
4917486 April 17, 1990 Raven et al.
4931053 June 5, 1990 L'Esperance, Jr.
4941093 July 10, 1990 Marshall et al.
4951663 August 28, 1990 L'Esperance, Jr.
4953969 September 4, 1990 Fedorov
4966577 October 30, 1990 Crosson et al.
4972836 November 27, 1990 Schenck et al.
4973330 November 27, 1990 Azema et al.
4976709 December 11, 1990 Sand
4988348 January 29, 1991 Bille
4994058 February 19, 1991 Raven et al.
5000561 March 19, 1991 Lawniczak et al.
5000751 March 19, 1991 Schroder et al.
5002571 March 26, 1991 O'Donnell, Jr. et al.
5013311 May 7, 1991 Nouri
5019074 May 28, 1991 Muller
5041134 August 20, 1991 O'Donnell
5048946 September 17, 1991 Sklar et al.
5049147 September 17, 1991 Danon
5054907 October 8, 1991 Sklar et al.
5057102 October 15, 1991 Tomioka et al.
5067951 November 26, 1991 Greve
5090798 February 25, 1992 Kohayakawa
5092863 March 3, 1992 Schanzlin
5094521 March 10, 1992 Jolson et al.
5098426 March 24, 1992 Sklar et al.
5102409 April 7, 1992 Balgorod
5108388 April 28, 1992 Trokel
5108412 April 28, 1992 Krumeich et al.
5112328 May 12, 1992 Taboada et al.
5116114 May 26, 1992 Nakamura et al.
5122135 June 16, 1992 Durr et al.
5123902 June 23, 1992 Muller et al.
5128509 July 7, 1992 Black et al.
5133708 July 28, 1992 Smith
5137530 August 11, 1992 Sand
5141506 August 25, 1992 York
5147349 September 15, 1992 Johnson et al.
5147352 September 15, 1992 Azema et al.
5152055 October 6, 1992 L'Esperance, III et al.
5152759 October 6, 1992 Parel et al.
5163934 November 17, 1992 Munnerlyn
5171242 December 15, 1992 Dewey et al.
5174021 December 29, 1992 L'Esperance, III et al.
5178635 January 12, 1993 Gwon et al.
5188631 February 23, 1993 L'Esperance, Jr.
5194948 March 16, 1993 L'Esperance, III et al.
5196006 March 23, 1993 Klopotek et al.
5196027 March 23, 1993 Thompson et al.
5201730 April 13, 1993 Easley et al.
5202708 April 13, 1993 Sasaki et al.
5203353 April 20, 1993 Easley et al.
5207668 May 4, 1993 L'Esperance, Jr.
5213092 May 25, 1993 Uram
5215104 June 1, 1993 Steinert
5217459 June 8, 1993 Kamerling
5219343 June 15, 1993 L'Esperance, Jr.
5219344 June 15, 1993 Yoder, Jr.
5222981 June 29, 1993 Werblin
5224942 July 6, 1993 Beuchat et al.
5226903 July 13, 1993 Mizuno
5246435 September 21, 1993 Bille et al.
5246436 September 21, 1993 Rowe
5257988 November 2, 1993 L'Esperance, Jr.
5258025 November 2, 1993 Fedorov et al.
5263950 November 23, 1993 L'Esperance, Jr.
5263951 November 23, 1993 Spears et al.
5275593 January 4, 1994 Easley et al.
5277911 January 11, 1994 Viegas et al.
5279298 January 18, 1994 Flower
5279611 January 18, 1994 McDonnell et al.
5281211 January 25, 1994 Parel et al.
5282798 February 1, 1994 Bruse et al.
5284477 February 8, 1994 Hanna et al.
5288293 February 22, 1994 O'Donnell, Jr.
5290272 March 1, 1994 Burstein et al.
5295989 March 22, 1994 Nakamura
5300020 April 5, 1994 L'Esperance, Jr.
5300061 April 5, 1994 Easley et al.
5300062 April 5, 1994 Ueno
5300063 April 5, 1994 Tano et al.
5300114 April 5, 1994 Gwon et al.
5304168 April 19, 1994 Sun
5304169 April 19, 1994 Sand
5311224 May 10, 1994 Enomoto
5312320 May 17, 1994 L'Esperance, Jr.
5312393 May 17, 1994 Mastel
5314422 May 24, 1994 Nizzola
5318047 June 7, 1994 Davenport et al.
5318560 June 7, 1994 Blount et al.
5323788 June 28, 1994 Silvestrini et al.
5324281 June 28, 1994 Muller
5325134 June 28, 1994 Kohayakawa
5334190 August 2, 1994 Seiler
5336215 August 9, 1994 Hsueh et al.
5336216 August 9, 1994 Dewey
5342351 August 30, 1994 Blaha et al.
5342370 August 30, 1994 Simon et al.
5345948 September 13, 1994 O'Donnell, Jr.
5346491 September 13, 1994 Oertli
5347329 September 13, 1994 Ota
5348551 September 20, 1994 Spears et al.
5350374 September 27, 1994 Smith
5354331 October 11, 1994 Schachar
5355181 October 11, 1994 Ashizaki et al.
5356407 October 18, 1994 Easley et al.
5356409 October 18, 1994 Nizzola
5360424 November 1, 1994 Klopotek
5364388 November 15, 1994 Koziol
5364390 November 15, 1994 Taboada et al.
5368590 November 29, 1994 Itoh
5370641 December 6, 1994 O'Donnell, Jr.
5372595 December 13, 1994 Gaasterland et al.
5374265 December 20, 1994 Sand
5376086 December 27, 1994 Khoobehi et al.
5391165 February 21, 1995 Fountain et al.
5395356 March 7, 1995 King et al.
5403307 April 4, 1995 Zelman
5408484 April 18, 1995 Weimel
5411501 May 2, 1995 Klopotek
5412561 May 2, 1995 Rosenshein et al.
5413555 May 9, 1995 McMahan
5423798 June 13, 1995 Crow
5423800 June 13, 1995 Ren et al.
5423801 June 13, 1995 Marshall et al.
5425727 June 20, 1995 Koziol
5425729 June 20, 1995 Ishida et al.
5425730 June 20, 1995 Luloh
5437657 August 1, 1995 Epstein
5437658 August 1, 1995 Muller et al.
5439462 August 8, 1995 Bille et al.
5441496 August 15, 1995 Easley et al.
5441511 August 15, 1995 Hanna
5442412 August 15, 1995 Frey et al.
5442487 August 15, 1995 Mizuno
5445633 August 29, 1995 Nakamura et al.
5460627 October 24, 1995 O'Donnell, Jr.
5461212 October 24, 1995 Seiler et al.
5462739 October 31, 1995 Dan et al.
5465737 November 14, 1995 Schachar
5470329 November 28, 1995 Sumiya
5474548 December 12, 1995 Knopp et al.
5476511 December 19, 1995 Gwon et al.
5480396 January 2, 1996 Simon et al.
5484432 January 16, 1996 Sand
5489299 February 6, 1996 Schachar
5503165 April 2, 1996 Schachar
5507740 April 16, 1996 O'Donnell, Jr.
5514124 May 7, 1996 Alpins
5514125 May 7, 1996 Lasser et al.
5520679 May 28, 1996 Lin
5527774 June 18, 1996 Girard
5529076 June 25, 1996 Schachar
5531753 July 2, 1996 Oliveira
5533997 July 9, 1996 Ruiz
5548352 August 20, 1996 Dewey
5549597 August 27, 1996 Shimmick et al.
5549632 August 27, 1996 Lai
5556395 September 17, 1996 Shimmick et al.
5573544 November 12, 1996 Simon et al.
5594753 January 14, 1997 Frey et al.
5607472 March 4, 1997 Thompson
5616139 April 1, 1997 Okamoto
5618284 April 8, 1997 Sand
5620435 April 15, 1997 Belkin et al.
5627162 May 6, 1997 Gwon et al.
5632742 May 27, 1997 Frey et al.
5651782 July 29, 1997 Simon et al.
5656186 August 12, 1997 Mourou et al.
5684560 November 4, 1997 Roffman et al.
5699142 December 16, 1997 Lee et al.
5709868 January 20, 1998 Perricone
5722952 March 3, 1998 Schachar
5722970 March 3, 1998 Colvard et al.
5731909 March 24, 1998 Schachar
5738677 April 14, 1998 Colvard et al.
5752950 May 19, 1998 Frey et al.
5757462 May 26, 1998 Nanjo
5766171 June 16, 1998 Silvestrini
5773472 June 30, 1998 Stjernschantz et al.
5828686 October 27, 1998 Frey et al.
5843184 December 1, 1998 Cionni
5849006 December 15, 1998 Frey et al.
5886768 March 23, 1999 Knopp et al.
5907908 June 1, 1999 Cunanan et al.
5912915 June 15, 1999 Reed et al.
5919186 July 6, 1999 Bath
5928129 July 27, 1999 Ruiz
5980513 November 9, 1999 Frey et al.
5984916 November 16, 1999 Lai
5993441 November 30, 1999 Muller et al.
6007578 December 28, 1999 Schachar
6013101 January 11, 2000 Israel
6019472 February 1, 2000 Koester et al.
6022088 February 8, 2000 Metzler
6027494 February 22, 2000 Frey
6050687 April 18, 2000 Bille et al.
6055259 April 25, 2000 Frey et al.
6059772 May 9, 2000 Hsia et al.
6070981 June 6, 2000 Mihashi et al.
6099522 August 8, 2000 Knopp et al.
6114651 September 5, 2000 Schluter et al.
6132424 October 17, 2000 Tang
6186148 February 13, 2001 Okada
6190375 February 20, 2001 Frey
6197018 March 6, 2001 O'Donnell
6197056 March 6, 2001 Schachar
6252595 June 26, 2001 Birmingham et al.
6254595 July 3, 2001 Juhasz et al.
6261220 July 17, 2001 Frey et al.
6271914 August 7, 2001 Frey et al.
6271915 August 7, 2001 Frey et al.
6275718 August 14, 2001 Lempert
6280435 August 28, 2001 Odrich et al.
6280468 August 28, 2001 Schachar
6299640 October 9, 2001 Schachar
6302879 October 16, 2001 Frey et al.
6312422 November 6, 2001 Duback
6312424 November 6, 2001 Largent
6313165 November 6, 2001 Grunberger et al.
6315773 November 13, 2001 Frey et al.
6319274 November 20, 2001 Shadduck
6322545 November 27, 2001 Schachar
6322556 November 27, 2001 Gwon et al.
6324191 November 27, 2001 Horvath
6325791 December 4, 2001 Shimoji
6325792 December 4, 2001 Swinger et al.
6328732 December 11, 2001 Donitzky et al.
6344040 February 5, 2002 Juhasz et al.
6373571 April 16, 2002 Juhasz et al.
D459806 July 2, 2002 Webb
D459807 July 2, 2002 Webb
6413262 July 2, 2002 Saishin et al.
D462442 September 3, 2002 Webb
D462443 September 3, 2002 Webb
6451008 September 17, 2002 Frey et al.
6460997 October 8, 2002 Frey et al.
6467906 October 22, 2002 Alpins
6493151 December 10, 2002 Schachar
6494910 December 17, 2002 Ganem et al.
6497483 December 24, 2002 Frey et al.
6530917 March 11, 2003 Seiler et al.
6544254 April 8, 2003 Bath
6547394 April 15, 2003 Doherty
6554825 April 29, 2003 Murray et al.
6585726 July 1, 2003 Frey et al.
6588902 July 8, 2003 Isogai
6588903 July 8, 2003 Rathjen
6592574 July 15, 2003 Shimmick et al.
6610686 August 26, 2003 Enrico et al.
6623476 September 23, 2003 Juhasz et al.
6626445 September 30, 2003 Murphy et al.
6626893 September 30, 2003 Frey et al.
6626894 September 30, 2003 Frey et al.
6626895 September 30, 2003 Frey et al.
6626896 September 30, 2003 Frey et al.
6626897 September 30, 2003 Frey et al.
6626898 September 30, 2003 Frey et al.
6648877 November 18, 2003 Juhasz et al.
6669342 December 30, 2003 Liebermann et al.
6676653 January 13, 2004 Juhasz et al.
6693927 February 17, 2004 Horvath et al.
6726679 April 27, 2004 Dick et al.
6849091 February 1, 2005 Cumming
6863667 March 8, 2005 Webb et al.
6905641 June 14, 2005 Platt et al.
6923955 August 2, 2005 Till et al.
6962583 November 8, 2005 Kadziauskas et al.
7044568 May 16, 2006 Olivera et al.
7077838 July 18, 2006 Wong
7182759 February 27, 2007 Kadziauskas et al.
7188949 March 13, 2007 Bandhauer et al.
7220255 May 22, 2007 Lai
7252662 August 7, 2007 McArdle et al.
7264355 September 4, 2007 Rathjen
RE40002 January 15, 2008 Lin
RE40184 March 25, 2008 Lin
7338167 March 4, 2008 Zelvin et al.
7357504 April 15, 2008 Fischer et al.
7364575 April 29, 2008 Van Saarloos
7390089 June 24, 2008 Loesel et al.
RE40420 July 1, 2008 Dick et al.
7402159 July 22, 2008 Loesel et al.
7467871 December 23, 2008 Lawhorn et al.
7479106 January 20, 2009 Banik et al.
7540613 June 2, 2009 Severns
7655002 February 2, 2010 Myers
7717908 May 18, 2010 Ruiz et al.
7766903 August 3, 2010 Blumenkranz et al.
7836894 November 23, 2010 Brinkmann et al.
7959289 June 14, 2011 Cattin-Liebl
8262553 September 11, 2012 Weston et al.
8262646 September 11, 2012 Frey et al.
8382745 February 26, 2013 Naranjo-Tackman et al.
8465478 June 18, 2013 Frey et al.
8475433 July 2, 2013 Mrochen et al.
8480659 July 9, 2013 Frey et al.
8500723 August 6, 2013 Frey et al.
8556425 October 15, 2013 Frey et al.
D694890 December 3, 2013 Bott et al.
D695408 December 10, 2013 Bott et al.
8617146 December 31, 2013 Naranjo-Tackman et al.
20010029363 October 11, 2001 Lin
20020004658 January 10, 2002 Munnerlyn et al.
20020025311 February 28, 2002 Till
20020029053 March 7, 2002 Gordon
20020049437 April 25, 2002 Silvestrini
20020049450 April 25, 2002 Myers
20020103478 August 1, 2002 Gwon et al.
20020110549 August 15, 2002 Till
20020138139 September 26, 2002 Till
20020140903 October 3, 2002 Schachar
20020159028 October 31, 2002 Masaki
20030050629 March 13, 2003 Kadziauskas et al.
20030055412 March 20, 2003 Lieberman et al.
20030076477 April 24, 2003 Matsumoto
20030076508 April 24, 2003 Cornsweet
20030109926 June 12, 2003 Portney
20030135272 July 17, 2003 Brady et al.
20030139737 July 24, 2003 Lin
20030212387 November 13, 2003 Kurtz et al.
20030220630 November 27, 2003 Lin et al.
20030236515 December 25, 2003 Lieberman et al.
20040054359 March 18, 2004 Ruiz et al.
20040059321 March 25, 2004 Knopp et al.
20040070761 April 15, 2004 Horvath et al.
20040106929 June 3, 2004 Masket
20040143244 July 22, 2004 Grey et al.
20040156014 August 12, 2004 Piers et al.
20040199149 October 7, 2004 Myers et al.
20040199150 October 7, 2004 Lai
20040243111 December 2, 2004 Bendett et al.
20040249403 December 9, 2004 Loomas et al.
20050107773 May 19, 2005 Bergt et al.
20050107775 May 19, 2005 Huang et al.
20050165387 July 28, 2005 Lubatschowski et al.
20050197655 September 8, 2005 Telfair et al.
20050203492 September 15, 2005 Nguyen et al.
20050241653 November 3, 2005 Van Heugten et al.
20050243276 November 3, 2005 Van Heugten et al.
20050270486 December 8, 2005 Teiwes et al.
20050286019 December 29, 2005 Wiltberger et al.
20060058682 March 16, 2006 Miller et al.
20060084956 April 20, 2006 Sumiya
20060192921 August 31, 2006 Loesel et al.
20060195076 August 31, 2006 Blumenkranz et al.
20060215111 September 28, 2006 Mijashi
20060217688 September 28, 2006 Lai
20060259022 November 16, 2006 Lin
20070010803 January 11, 2007 Bischoff et al.
20070078447 April 5, 2007 Weinacht et al.
20070093795 April 26, 2007 Melcher et al.
20070093796 April 26, 2007 Raksi et al.
20070129693 June 7, 2007 Hunter et al.
20070173794 July 26, 2007 Frey et al.
20070173795 July 26, 2007 Frey et al.
20070185475 August 9, 2007 Frey et al.
20070265603 November 15, 2007 Pinelli
20080058841 March 6, 2008 Kurtz et al.
20080071254 March 20, 2008 Lummis et al.
20080077121 March 27, 2008 Rathjen
20080111972 May 15, 2008 Barth et al.
20080114386 May 15, 2008 Iliakis et al.
20080186551 August 7, 2008 Hanft et al.
20080275433 November 6, 2008 Russmann et al.
20080281303 November 13, 2008 Culbertson et al.
20080281413 November 13, 2008 Culbertson et al.
20080312675 December 18, 2008 Newcott et al.
20090012507 January 8, 2009 Culbertson et al.
20090069794 March 12, 2009 Kurtz
20090088734 April 2, 2009 Mordaunt
20090126870 May 21, 2009 Zadoyan et al.
20090131921 May 21, 2009 Kurtz
20090137988 May 28, 2009 Kurtz
20090137991 May 28, 2009 Kurtz
20090137993 May 28, 2009 Kurtz
20090157063 June 18, 2009 Ruiz
20090161065 June 25, 2009 Smith, III et al.
20090171327 July 2, 2009 Kurtz et al.
20090177189 July 9, 2009 Raksi
20090187178 July 23, 2009 Muller et al.
20090192389 July 30, 2009 Eilers et al.
20090244482 October 1, 2009 Elsner et al.
20090281530 November 12, 2009 Korn
20090287232 November 19, 2009 Davis
20100002837 January 7, 2010 Gertner et al.
20100004641 January 7, 2010 Frey et al.
20100004643 January 7, 2010 Frey et al.
20100022994 January 28, 2010 Frey et al.
20100022995 January 28, 2010 Frey et al.
20100022996 January 28, 2010 Frey et al.
20100042079 February 18, 2010 Frey et al.
20100060855 March 11, 2010 Graether
20100114079 May 6, 2010 Myers et al.
20100249761 September 30, 2010 Ruiz et al.
20100256614 October 7, 2010 Donitzky et al.
20100256615 October 7, 2010 Blumenkranz et al.
20100274228 October 28, 2010 Mrochen et al.
20100292676 November 18, 2010 Larsen
20100292678 November 18, 2010 Frey et al.
20100312231 December 9, 2010 Singh
20100324542 December 23, 2010 Kurtz
20100331829 December 30, 2010 Bor et al.
20110022035 January 27, 2011 Porter et al.
20110022036 January 27, 2011 Frey et al.
20110028950 February 3, 2011 Raksi et al.
20110040293 February 17, 2011 Bor
20110092965 April 21, 2011 Slatkine
20110118712 May 19, 2011 Lubatschowski et al.
20110137301 June 9, 2011 Bartoli
20110149240 June 23, 2011 Alpins
20110160711 June 30, 2011 Naranjo-Tackman et al.
20110166557 July 7, 2011 Naranjo-Tackman et al.
20110172649 July 14, 2011 Schuele et al.
20110184395 July 28, 2011 Schuele et al.
20110187995 August 4, 2011 Frey et al.
20110190739 August 4, 2011 Frey et al.
20110190740 August 4, 2011 Frey et al.
20110292340 December 1, 2011 Shimizu et al.
20120016350 January 19, 2012 Myers et al.
20120089134 April 12, 2012 Horvath et al.
20120182522 July 19, 2012 Frey et al.
20120229767 September 13, 2012 Alpins
20120265181 October 18, 2012 Frey
20120271286 October 25, 2012 Curatu et al.
20120296321 November 22, 2012 Frey et al.
20120330290 December 27, 2012 Gray et al.
20130265542 October 10, 2013 Frey et al.
Foreign Patent Documents
2553963 August 2005 CA
2680072 September 2008 CA
0 397 962 November 1990 EP
0 933 060 August 1999 EP
1 970 034 September 2008 EP
2 497 087 July 1982 FR
5-115437 May 1993 JP
WO 91/19539 December 1991 WO
WO 01/13838 March 2001 WO
WO 03/002010 January 2003 WO
WO 2005/070358 August 2005 WO
WO 2006/074469 July 2006 WO
WO 2008/112292 September 2008 WO
WO 2012/051490 April 2012 WO
Other references
  • U.S. Appl. No. 11/337,127, filed Jan. 20, 2006, Frey et al.
  • U.S. Appl. No. 11/414,819, filed May 1, 2006, Frey et al.
  • U.S. Appl. No. 12/217,285, filed Jul. 2, 2008, Frey et al.
  • U.S. Appl. No. 12/217,295, filed Jul. 2, 2008, Frey et al.
  • U.S. Appl. No. 12/509,021, filed Jul. 24, 2009, Frey et al.
  • U.S. Appl. No. 12/509,211, filed Jul. 24, 2009, Frey et al.
  • U.S. Appl. No. 12/509,412, filed Jul. 24, 2009, Frey et al.
  • U.S. Appl. No. 12/685,850, filed Jan. 12, 2010, Myers et al.
  • U.S. Appl. No. 12/831,845, filed Jul. 7, 2010, Naranjo-Tackman et al.
  • U.S. Appl. No. 12/831,859, filed Jul. 7, 2010, Naranjo-Tackman et al.
  • U.S. Appl. No. 12/840,818, filed Jul. 21, 2010, Porter et al.
  • U.S. Appl. No. 12/842,870, filed Jul. 23, 2010, Frey et al.
  • U.S. Appl. No. 29/377,018, filed Oct. 15, 2010, Bott et al.
  • U.S. Appl. No. 29/377,054, filed Oct. 15, 2010, Bott et al.
  • U.S. Appl. No. 13/016,593, filed Jan. 28, 2011, Frey et al.
  • U.S. Appl. No. 13/017,499, filed Jan. 31, 2011, Frey et al.
  • U.S. Appl. No. 13/017,702, filed Jan. 31, 2011, Frey et al.
  • U.S. Appl. No. 13/243,406, filed Sep. 23, 2011, Myers et al.
  • U.S. Appl. No. 13/273,653, filed Oct. 14, 2011, Frey et al.
  • U.S. Appl. No. 13/427,130, filed Mar. 22, 2012, Frey.
  • U.S. Appl. No. 13/427,149, filed Mar. 22, 2012, Frey et al.
  • U.S. Appl. No. 13/427,319, filed Mar. 22, 2012, Grey et al.
  • U.S. Appl. No. 13/435,103, filed Mar. 30, 2012, Curatu et al.
  • U.S. Appl. No. 13/681,004, filed Nov. 19, 2012, Frey et al.
  • FDA PMA P030002 titled “crystalens™ Model AT-45 Accomodating Posterior Chamber Intraocular Lens (OIO)”, dated Nov. 14, 2003, 16 pgs.
  • FDA PMA P040020 titled “AcrySof® ResSTOR® Apodized Diffractive Optic Posterior Chamber Intraocular Lenses, Models MA60d3 and SA60D3”, dated Mar. 21, 2005, 29 pgs.
  • Unpublished U.S. Appl. No. 13/681,004, filed Nov. 19, 2012 (57 pgs).
  • International Search Report and Written Opinion for related application No. PCT/US2010/041286, dated Sep. 14, 2010, 8 pgs.
  • Author unknown, “Statement of the Use of Animals in Opthalmic and Visual Research”, The Association for Research in Vision and Opthalmology, Obtained from the Internet at: http//www.arvo.org/aboutavro as of Nov. 18, 2010, 3 pgs.
  • Akchurin, Garif et al., “Evaluation of the degree of turbidity if cataract lens and its correlation with retinal visual acuity”, SPIE, vol. 3591, Jan. 1999, pp. 74-81.
  • Al-Ghoul, K. J. et al., “Distribution and Type of Morphological Damage in Human Nuclear Age-Related Cataracts”, Department of Cell Biology and Anatomy, University of North Carolina and Duke University Eye Center, 1996, pp. 237-251.
  • Al-Ghoul, Kristin J. et al., “Structural Evidence of Human Nuclear Fiber Compaction as a Function of Ageing and Cataractogenesis”, Exp. Eye Res., vol. 72, 2001, pp. 199-214.
  • Alio, et al., “Crystalline Lens Optical Dysfunction through Aging”, Ophthalmology, vol. 112, No. 11, Nov. 2005, pp. 2022-2029.
  • Amann, Josef et al., “Increased Endothelial Cell Density in the Paracentral and Peripheral Regions of the Human Cornea”, American Journal of Ophthalmology, vol. 135, No. 5, May 2003, pp. 584-590.
  • Amendt, M. Strauss et al., “Modeling of bubble dynamics in relation to medical applications”, Proc. of SPIE, vol. 2975, 1997, pp. 362-373.
  • Ansari, Rafat R. et al., “Measuring lens opacity: combining quasi-elastic light scattering with Scheimpflug imaging system”, Proc. of SPIE, vol. 3246, 1998, pp. 35-42.
  • Anschutz, Till, M.D., “Laser Correction of Hyperopia and Presbyopia”, vol. 34, No. 4, 1994, pp. 107-137.
  • Apple, David J. et al., “Preparation and Study of Human Eyes Obtained Postmortem with the Miyake Posterior Photographic Technique”, Ophthalmology, vol. 97, No. 6, Jun. 1990, pp. 810-816.
  • Armstrong, Larry “A cataract Breakthrough May Be on the Way”, Business Week, Mar. 23, 1998, pp. 90-92.
  • Aston, Adam, “Why Settle for 20/20?”, Business Week, Mar. 17, 2003, pp. 95-96.
  • Azzam, Naiel et al., “Long-term lens organ culture system to determine age-related effects of UV irradiation on the eye lens”, Experimental Eye Research, vol. 79, 2004, pp. 903-911.
  • Back, Arthur P. et al., “Correction of Presbyopia with Contact Lenses: Comparative Success Rates with Three Systems”, Optometry & Vision Science, 1989, vol. 66, No. 8, pp. 518-525.
  • Balaram, Mini et al., Noncontact Specular Microscopy of Human Lens Epithelium, IOVS, vol. 41, No. 2, Feb. 2000, pp. 474-481.
  • Barak, Adiel et al., “Anterior capsulotomy using the CO2 laser”, Proc. of SPIE, vol. 3246, 1998, pp. 196-198.
  • Bath, Patricia E. et al., “Endocapsular Excimer Laser Phakoablation Through a 1-mm Incision”, Opthalmic Laser Therapy, vol. 2, No. 4, 1987, pp. 245-249.
  • Beers, A. P. A. et al. “Age-Related Changes in the Accommodation Mechanism”, Optometry and Vision Science, 1996, vol. 73, No. 4, pp. 235-242.
  • Beers, A. P. A. et al., “In Vivo Determination of the Biomechanical Properties of the Component Elements of the Accommodation Mechanism”, Vision Res., vol. 34, 1994, pp. 2897-2905.
  • Bellows, John G., M.D. et al., “B. Cataracta Complicata”, Traumatic Cataract, undated but prior to Jul. 2009, pp. 270-272.
  • Ben-Sira, I. et al., “Clinical method for measurement of light back scattering from the in vivo human lens”, Invest. Ophthalmol. Vis. Sci., vol. 19, No. 4 (Reports), Apr. 1980, pp. 435-437.
  • Benjamin, William J., “Borish's Clinical Refraction”, W.B. Saunders, publishers, copyright 1998, p. 110.
  • Bettelheim, Frederick A. et al., “Syneretic Response of Aging Normal Human Lens to Pressure”, Investigative Ophthalmology & Visual Science, vol. 44, No. 1, Jan. 2003, pp. 258-263.
  • Bigler, Emmanuel, “Depth of field and Scheimpflug's rule: a “minimalist” geometrical approach”, published unknown, 2002, pp. 1-17.
  • Billie, J. F. et al., “3D Imaging of the Human Eye Using the laser Tomographic Scanner Lts”, publisher unknown, undated but prior to Jul. 2009, 2 pgs.
  • Bito, L.Z. et al., “Age-dependent loss of accommodative amplitude in rhesus monkeys: an animal model for presbyopia”, Invest. Ophthalmol. Vis. Sci., vol. 23, No. 1, Jul. 1982, pp. 23-31.
  • Bliss, E. S., “Pulse Duration Dependence of laser Damage Mechamisms”, Opto-Electronics, vol. 3, 1971, pp. 99-108.
  • Bor, Zs. PhD., et al., “Plume Emission, Shock Wave and Surface Wave Formation During Excimer Laser Ablation of the Cornea”, Supplement to Retroactive & Corneal Surgery, vol. 9, Mar./Apr. 1993, pp. S111-S115.
  • Borja, David et al., “Crystalline Lens MTF Measurement During Simulated Accommodation”, Proc. of SPIE, 2005, vol. 5688, pp. 26-32.
  • Borkman, Raymond F. et al., “Evidence for a Free Radical Mechanism in Aging and u.v.-Irradiated Ocular Lenses”, Exp. Eye Res., 1977, vol. 25, pp. 303-309.
  • Braham, Lewis, “Eye Surgery: It's Getting Sharper”, Business Week, Oct. 18, 2004, pp. 142-143.
  • Breitenfeld, P. et al., “Finite Element Method-Simulation of the Human Lens During Accommodation”, publiasher unknown, vol. 5863, 2005, 9 pgs.
  • Breitling, Detlef et al., “Fundamental aspects in machining of metals with short and ultrashort laser pulses”, Proc. of SPIE, vol. 5339, 2004, pp. 1-15.
  • Brian, G. et al., “Cataract Blindness—Challenges for the 21st Century”, Bulletin of the World Health Organization, vol. 79, No. 3, 2001, pp. 249-256.
  • Bron, A.J., “The Ageing Lens”, Opthalmologics, vol. 214, 2000, pp. 86-104.
  • Brown, Nicholas, “Dating the onset of cataract”, Transactions of the Ophthalmological Society of the United Kingdom, vol. 96, 1976, pp. 18-23.
  • Brown, Nicholas “The Change in Lens Curvature with Age”, Exp. Eye Res. (1974), vol. 19, pp. 175-183.
  • Brown, Nicholas “The Change in Shape and Internal Form of the Lens of the Eye on Accommodation”, Exp. Eye Res. (1973) vol. 15, pp. 441-459.
  • Burd, H.J. et al., “Can reliable values of Young's modulus be deduced from Fisher's (1971) spinning lens measurements?”,Vision Research, vol. unknown, 2005, pp. 1-15.
  • Burd, H.J. et al., “Numerical modeling of the accommodating lens”, Vision Research, vol. 42, 2002, pp. 2235-2251.
  • Campbell, Melanie C. W., “Measurement of Refractive Index in an Intact Crystalline Lens”, Vision Research, vol. 24, No. 5, 1984, pp. 409-415.
  • Carey, James et al., “Propagation and Characterization of Ultrashort Laser Pulses”, Harvard University, 2003, pp. 1-30.
  • Chaker, M. et al., “Interaction of a 1 psec laser pulse with solid matter”, Phys. Fluids B 3, vol. 1, Jan. 1991, pp. 167-175, plus cover page.
  • Charles, M. W. et al., “Dimensions of the Human Eye Relevant to Radiation Protection”, Phys. Med. Biol., 1975, vol. 20, No. 2, © 1975, pp. 202-218.
  • Chen, Wei-Li et al., Ultrasound Biomicroscopic Findings in Rabbit Eyes Undergoing Scleral Suction during Lamellar Refractive Surgery, IOVS, vol. 43, No. 12, Dec. 2002, pp. 3665-3672.
  • Chien, C. Y. et al., “Production of a high-density and high-temperature plasma with an intense high-contrast subpicosecond laser”, Optics Letters, vol. 18, No. 18, Sep. 15, 1993, pp. 1535-1537.
  • Claflin, E. S. et al., “Configuring an electrostatic membrane mirror by least-squares fitting with analytically derived influence functions”, J. Opt. Soc. Am. A., vol. 3, No. 11, 1986, pp. 1833-1839.
  • Coleman, D. Jackson et al., “Presbyopia, Accommodation, and the Mature Catenary”, Ophthalmology, vol. 108, No. 9, Sep. 2001, pp. 1544-1551.
  • Cook, Christopher A. et al., “Aging of the Human Crystalline Lens and Anterior Segment”, Vision Res., 1994, vol. 34, No. 22, pp. 2945-2954.
  • Corkum, P. B. et al., “Thermal Response of Metals to Ultrashort-Pulse Laser Excitation”, Physical Review Letters, vol. 61, No. 25, Dec. 19, 1988, pp. 2886-2889.
  • Costagliola, Ciro et al., “ArF 193 nm Excimer Laser Corneal Surgery as a Possible Risk Factor in Cataractogenesis”, Exp. Eye Res., 1994, vol. 58, pp. 453-457.
  • Cotlier, Edward, M.D., “The Lens”, Adler's Physiology of the Eye, copyright 2003, pp. 268-290.
  • Crawford, Kathryn S. et al., “The Role of the Iris in Accommodation of Rhesus Monkeys”, Investigative Ophthalmology & Visual Science, vol. 31, No. 10, Oct. 1990, pp. 2185-2190.
  • Croft, Mary Ann et al., “Accommodation and Presbyopia”, publisher unknown, vol. 41, 2001, pp. 33-46.
  • Croft, Mary Ann et al., “Accommodation and Presbyopia: The Ciliary Neuromuscular View”, Opthalmol Clin N Am, vol. 19, 2006, pp. 13-24.
  • Croft, Mary Ann et al., Accommodative Ciliary Body and Lens Function in Rhesus Monkeys, I: Normal Lens, Zonule and Ciliary Process Configuration in the Iridectomized Eye, IOVS, vol. 47, No. 3, Mar. 2006, pp. 1076-1086.
  • Croft, Mary Ann et al., “The Zonula, Lens, and Circumlental Space in the Normal Iridectomized Rhesus Monkey Eye”, IOVS, vol. 47, No. 3, Mar. 2006, pp. 1087-1095.
  • Cromie, William J., “Laser Makes History's Fastest Holes”, The Harvard University Gazette, 1999, obtained at: http://www.news.harvard.edu/gazette/1999/10.07/laser.html, 6 pags.
  • Czygan, G. et al., “Mechanical testing of isolated senile human eye lens nuclei”, Med. Eng. Phys., vol. 18, No. 5, 1996, pp. 345-349.
  • Datta, Debajyoti, “Tissue Surgery and Subcellular Photodisruption with Femtosecond Laser Pulses”, Thesis for Dept. of Physics, Harvard University, May 2002, pp. 1-74.
  • Dausinger, Friedrich et al., “Micro-machining with ultrashort laser pulses: From basic understanding to technical applications”, publisher unknown, undated but prior to Jul. 2009, pp. 1-10.
  • Dholakia, Sheena A. et al., “Prospective evaluation of phacoemulsification in adults younger than 50 years”, J Cataract Refract Surg, vol. 31, 2005, pp. 1327-1333.
  • Douven, Lucien F.A. et al., “Characterization of Mechanical Behaviour of Human Skin in Vivo”, Proc. of SPIE, vol. 3914, 2000, pp. 618-629.
  • Du, D. et al., “Laser-induced breakdown by impact ionization in SiO2 with pulse widths from 7 ns to 150 fs”, Appl. Phys. Lett., vol. 64, No. 23, Jun. 6, 1994, pp. 3071-3073.
  • Ehrmann, Klaus et al., “Evaluation of porcine crystalline lenses in comparison with molded polymer gel lenses with an improved ex vivo accommodation simulator”, Proc. of SPIE, vol. 5688, 2005, pp. 240-251.
  • Ehrmann, Klaus et al., “Ex Vivo Accommodation Simulator II—Concept and Preliminary Results”, Proc. of SPIE, vol. 5314, 2004, pp. 48-58.
  • Eisner, Georg, “Eye Surgery—An Introduction to operative technique”, Springer-Verlag, Berlin, 1980, pp. 14-19.
  • El-Osta, Austen A.R. et al., “In vitro model for the study of human posterior capsule opacification”, J Cataract Refract Surg, vol. 29, 2003, pp. 1593-1600.
  • Erpelding, Todd N. et al., “Bubble-Based Acoustic Radiation Force for Monitoring Intraocular Lens Elasticity”, IEEE Intl Ultrasonics Symposium, vol. unknown, 2004, pp. 732-735.
  • Fagerholm, Per P.P., “The Response of the Lens to Trauma”, Trans. Ophtal. Soc. U. K., 1982, vol. 102, p. 369-374.
  • Farnsworth, P.N. et al., “Anterior Zonular Shifts with Age”, Exp. Eye Res., vol. 28, 1979, pp. 291-297.
  • Findl, Oliver et al., “Laserinterferometric Assessment of Pilocarpine-Induced Movement of an Accommodating Intraocular Lens—A Randomized Trial”, Ophthalmology, vol. 111, No. 8, Aug. 2004, pp. 1515-1521.
  • Fisher, R.F. et al., “Changes in lens fibres after damage to the lens capsule”, publisher unknown, undated but prior to Jul. 2009, 4 pgs.
  • Fisher, R.F., “Elastic Constants of the Human Lens Capsule”, J. Physiol., vol. 201, 1969, pp. 1-19.
  • Fisher, R.F., “Presbyopia and the Changes With Age in the Human Crystalline Lens”, J. Physiol., vol. 228, 1973, pp. 765-779.
  • Fisher, R. F., “The Ciliary Body in Accommodation”, Trans. Opthalmol. Soc. U.K., vol. 105, 1986, pp. 208-219.
  • Fisher, R.F., “The Elastic Constants of the Human Lens”, J. Physiol., vol. 212, 1971, pp. 147-180.
  • Fisher, R. F. et al., “The elastic constants and ultrastructural organization of a basement membrane (lens capsule)”, Proc. R. Soc. Lond. B., vol. 193, 1976, pp. 335-358.
  • Fisher, R.F., “The Force of Contraction of the Human Ciliary Muscle During Accommodation”, J. Physiol., vol. 270, 1977, pp. 51-74.
  • Fisher, R. F., “The Mechanics of Accommodation in Relation to Presbyopia”, Eye, vol. 2, 1988, pp. 646-649.
  • Fleck, Brian W. et al., “Q-switched Nd:YAG laser disruption of rabbit lens nucleus”, Laser and Light in Ophthalmology, 1990, vol. 3. No. 3, pp. 227-232.
  • Foster, C. Stephen et al., “Smolin and Thoft's The Cornea: Scientific Foundations and Clinical Practice”, The New England Journal of Medicine, vol. 353 No. 23, 2005, pp. 2519-2520.
  • Fujimoto, James et al., “Biomedical Optics”, Photonics West, Proc. of SPIE, vol. unknown, 2005, pp. 23-70.
  • Garner, LF et al., “Changes in Equivalent and Gradient Refractive Index of the Crystalline Lens with Accommodation”, Optom, Vis. Sci., vol. 74, No. 2, Feb. 1997, pp. 114-119.
  • Garner, LF et al., “Changes in Ocular Dimensions and Refraction with Accommodation”, Ophthal. Physiol. Opt., vol. 17, No. 1, 1997, pp. 12-17.
  • Garner, Margaret H. et al., “Selective oxidation of cysteine and methionine in normal and senile cataractous lenses”, Proc. Natl. Acad. Sci. USA, vol. 77, No. 3, Mar. 1980, pp. 1274-1277.
  • Gayen, Tapan K. et al., “Near-infrared laser welding of aortic and skin tissues and microscopic investigation of welding efficacy”, Proc. of SPIE, vol. 4949, 2003, pp. 182-185.
  • Gershenzon, A. et al., “Clinical and Epidemiology—New software for lens retro-illumination digital image analysis”, Australian and New Zealand Journal of Ophthalmology, 1999, vol. 27, pp. 170-172.
  • Giblin, Frank J. et al., “Nuclear Light Scattering, Disulfide Formation and Membrane Damage in Lenses of Older Guinea Pigs Treated with Hyperbaric Oxygen”, Exp. Eye Res., 1995, vol. 60, pp. 219-235.
  • Gills, James P., “Treating astigmatism at the time of cataract surgery”, Current Opinion in Ophthalmology, 2002, vol. 13, p. 2-6.
  • Gimbel, Howard V. et al., “Intrastromal Photorefractive Keratectomy with the Nd:YLF Laser”, publisher unknown, vol. 34, Iss. 4, 1994, pp. 139-145.
  • Glasser, Adrian et al., “Accommodative Changes in Lens Diameter in Rhesus Monkeys”, IOVS, vol. 47, No. 1, Jan. 2006, pp. 278-286.
  • Glasser, A. et al., “Biometric, optical and physical changes in the isolated human crystalline lens with age in relation to presbyopia”, Vision Research, vol. 39, 1999, pp. 1991-2015.
  • Glasser, Adrian et al., “On modeling the causes of presbyopia”, Vision Research, vol. 41, 2001, pp. 3083-3087.
  • Glasser, A. et al., “On the potential causes of presbyopia”, Vision Research, vol. 39, 1999, pp. 1267-1272.
  • Glasser, Adrian et al., “Presbyopia and the Optical Changes in the Human Crystalline Lens with Age”, Vision Res., vol. 38, No. 2, 1998, pp. 209-229.
  • Glasser, Adrian et al., “Ultrasound Biomicroscopy of the Aging Rhesus Monkey Ciliary Region”, Optometry and Vision Science, vol. 78, No. 6, 2001, pp. 417-424.
  • Goodenough, Daniel A., “Lens gap junctions: a structural hypothesis for nonregulated low-resistance intercellular pathways”, Invest. Ophthalmol. Visual Sci., vol. 18, No. 11, Nov. 1979, pp. 1104-1122.
  • Grace, Jeffery M. et al., “Repetitively Pulsed Ruby Lasers As Light Sources for High-Speed Photography”, Optical Engineering, vol. 37, No. 8, Aug. 1998, pp. 1-26.
  • Gwon, Arlene et al., “Focal laser photophacoablation of normal and cataractous lenses in rabbits: Preliminary report”, J Cataract Refract Surg, vol. 21, May 1995, pp. 282-286.
  • Habib, Maged S. et al., “Myopic Intrastromal Photorefractive Keratectomy With the Neodymium—Yttrium Lithium Fluoride Picosecond Laser in the Cat Cornea”, Arch Ophthalmol., vol. 113, Apr. 1995, pp. 499-505.
  • Hahn, D.W., “Dynamics of Ablation Plume Particles Generated During Excimer Laser Corneal Ablation”, Lasers in Surgery and Medicine, vol. 16, 1995, pp. 384-389.
  • Hamaoui, Marie et al., “Ex-vivo testing of crystalline lens substitutes: a pilot study”, Proc. of SPIE, vol. 3908, 2000, pp. 123-130.
  • Hammer, Daniel X. et al., “Dual OCT/SLO Imager with Three-Dimensional Tracker”, Proc. of SPIE, vol. 5688, 2005, pp. 33-44.
  • Hammer, Daniel et al., “Shielding Properties of Laser-Induced Breakdown in Water for Pulse Durations From 5 ns to 125 fs”, Applied Optics, 1997, vol. 36, No. 22, pp. 5630-5640.
  • Hanson, S.R.A. et al., “The major in vivo modifications of the human water-insoluble lens crystallins are disulfide bonds, deamidation, methionine oxidation and backbone cleavage”, Exp. Eye Res., vol. 71, 2000, pp. 195-207.
  • Hara, Tsutomu, M.D. et al., “Complications associated with endocapsular balloon implantation rabbit eyes”, J Cataract Refract Surg, vol. 20, Sep. 1994, pp. 507 and 512.
  • Harding, J. J., “Disulphide Cross-linked Protein of High Molecular Weight in Human Cataractous Lens”, Exp. Eye Res. (1973), vol. 17, pp. 377-383.
  • Hartwick, Andrew T. E. et al., “Ephitelial activity of hexokinase and glucose-6-phosphate dehydrogenase in cultured bovine lenses recovering from pharmaceutical-induced optical damage”, Molecular Vision, vol. 9, 2003, pp. 594-600.
  • Heisterkamp, Alexander et al., “Nonlinear effects inside corneal tissue after fs-photodisruption”, Proc. of SPIE, vol. 4433, 2001, pp. 55-60.
  • Heisterkamp, Alexander et al., “Pulse energy dependence of subcellular dissection by femtosecond laser pulses”, Optics Express, vol. 13, No. 10, May 2005, pp. 3690-3696.
  • Hemenger, Richard P. et al., “Change With Age of the Refractive Index Gradient of the Human Ocular Lens”, Investigative Ophthalmology & Visual Science, Mar. 1995. vol. 36, No. 3. pp. 703-707.
  • Heys, Karl Robert et al., “Massive increase in the stiffness of the human lens nucleus with age: the basis for presbyopia?”, Molecular Vision, vol. 10, 2004, pp. 956-963.
  • Ho, A. et al., “Feasibility of simultaneous correction of ametropia by varying gel refractive index with phaco-ersatz”, Proc. of SPIE, vol. 4245, 2001, pp. 119-128.
  • Hoffman, Richard S. et al., “Refractive lens exchange as a refractive surgery modality”, Copyright © 2004 Lippincott Williams & Wilkins, pp. 22-28.
  • Holzer, Mike P. et al., “Corneal flap complications in refractive surgery—Part 1: Development of an experimental animal model”, J Cataract Refract Surg, vol. 29, Apr. 2003, pp. 795-802.
  • Holzer, Mike P. et al., “Corneal flap complications in refractive surgery—Part 2: Postoperative treatments of diffuse lamellar keratitis in an experimental animal model”, J Cataract Refract Surg, vol. 29, Apr. 2003, pp. 803-807.
  • Horwitz, Joseph, “α-Crystallin can function as a molecular chaperone”, Proc. Natl. Acad. Sci. USA, vol. 89. Nov. 1992, pp. 10449-10453.
  • Hu, Tian-Sheng et al., “Reversal of Galactose Cataract with Sorbinil in Rats”, Investigative Ophthalmology & Visual Science, May 1983, vol. 24, pp. 640-644.
  • Huber, G. et al., “Room-temperature 2-μm HO:YAG and 3-μm ER:YAG Lasers”, Journal de Physique, undated but prior to Jul. 2009, 3 pgs.
  • Hunter, David, “First, Gather the Data”, New England Journal of Medicine, vol. 354, No. 4, Jan. 26, 2006, pp. 329-331.
  • Jacques, Paul F. et al., “Long-term vitamin C supplement use and prevalence of early age-related lens opacities”, Am J Clin Nutr, 1997; 66, pp. 911-916.
  • Johannesson, Mattias, “Active Range Imaging 2”, PhD-Thesis: SIMD architectures for Range and Radar Imaging, Linkoping Studies in Science and Technology, Dissertations No. 399, 2005, pp. 1-34.
  • Jones, C.E. et al., “Refractive index distribution and optical properties of the isolated human lens measured using magnetic resonance imaging (MRI)”, Vision Research, vol. 45, 2005, pp. 2352-2366.
  • Juhasz, Tibor, Ph.D. et al., “Dynamics of Shock Waves and Cavitation Bubbles Generated by Picosecond Laser Pulses in Corneal Tissue and Water”, Lasers in Surgery and Medicine, vol. 15, 1994, pp. 91-98.
  • Juhasz, T. et al., “Time resolved observations of shock waves and cavitatin bubbles generated by femtosecond laser pulses in corneal tissue and water”, Lasers in Surgery and Med, vol. 19, 1996, pp. 23-31.
  • Juhasz, T. et al., “Time-resolved Studies of Plasma-Mediated Surface Ablation of Soft Biological Tissue with Near-Infrared Picosecond Laser Pulses”, SPIE, vol. 2975, 1997, pp. 271-281.
  • Kasthurirangan, Sanjeev et al., “Amplitude dependent accommodative dynamics in humans”, Vision Research, vol. 43, 2003, pp. 2945-2956.
  • Kasthurirangan, Sanjeev, “Influence of Amplitude and Starting Point on Accommodative Dynamics in Humans”, IOVS, vol. 46, No. 9, Sep. 2005, pp. 3463-3472.
  • Kaufman, Paul L., M.D., “Accommodation and Presbyopia: Neuromuscular and Biophysical Aspects”, Adler's Physiology of the Eye, date unknown but prior to Jul. 2009, pp. 391-411.
  • Klem, D. E. et al., “The Interaction of Intense Femtosecond Laser Pulses with Solid Targets”, paper prepared under the auspices of the U.S. Dept. of Energy for the Short Wavelength V: Physics with Intense Laser Pulses Second Topical Meeting on Mar. 29-31, published Dec. 30, 1992, 1993, 6 pgs.
  • Keeney, Arthur H., M.D., “Intralenticular Foreign Bodies”, Arch Ophthal., vol. 86, Nov. 1971, pp. 499-501.
  • König, Karsten et al., “Are Femtosecond Lasers Safe for Ophthalmic Applications?”, Fraunhofer Institute of Biomedical Technologies, undated but prior to Jul. 2009, pp. 1-16.
  • König, Karsten et al., “Cornea surgery with nanojoule femtosecond laser pulses”, Proc. of SPIE, vol. 5688, 2005, pp. 288-293.
  • König, Karsten et al., “First in vivo animal studies on intraocular nanosurgery and multiphoton tomography with low-energy 80 MHz near infrared femtosecond laser pulses”, Proc. of SPIE, vol. 5314, 2004, pp. 262-269.
  • Koopmans, Steven A. et al., “Polymer Refilling of Presbyopic Human Lenses in Vitro Restores the Ability to Undergo Accommodative Changes”, IOVS, vol. 44, No. 1, Jan. 2003, pp. 250-257.
  • Koretz, Jane F. et al., “A Model for Accommodation in the Young Human Eye: The Effects of Lens Elastic Anisotropy on the Mechanism”, Vision Res., vol. 23, No. 12, 1983, pp. 1679-1686.
  • Koretz, Jane F. et al., “Accommodation and Presbyopia in the Human Eye—Aging of the Anterior Segment”, Vision Res., vol. 29, No. 12, 1989, pp. 1685-1692.
  • Koretz, Jane F. et al., “Accommodation and Presbyopia in the Human Eye—Changes in the Anterior Segment and Crystalline Lens With Focus”, IOVS, vol. 38, No. 3, Mar. 1997, pp. 569-578.
  • Koretz, Jane F. et al., “Analysis of Human Crystalline Lens Curvature as a Function of Accommodative State and Age”, Vision Res., vol. 24, No. 10, 1984, pp. 1141-1151.
  • Koretz, Jane F. et al., “How the Human Eye Focuses”, Scientific American, Jul. 1988, pp. 92-99.
  • Koretz, Jane F. et al., “Model of the Accommodative Mechanism in the Human Eye”, Vis. Res., vol. 22, 1982, pp. 917-927.
  • Koretz, Jane F. et al., “Scheimpflug and high-resolution magnetic resonance imaging of the anterior segment: a comparative study”, J. Opt. Soc. Am. A, vol. 21, No. 3, Mar. 2004, pp. 346-354.
  • Koretz, Jane F. et al., “The Zones of Discontinuity in the Human Lens: Development and Distribution with Age”, Vision Res., vol. 34, No. 22, 1994, pp. 2955-2962.
  • Krag, Susanne et al., “Biomechanical Characteristics of the Human Anterior Lens Capsule in Relation to Age”, Investigative Ophthalmology & Visual Science, vol. 38, No. 2, Feb. 1997, pp. 357-362.
  • Krag, Susanne, “Biomechanical measurements of the lens capsule”, Scandinavian University Theses, 1999, 3 pgs.
  • Krag, Susanne et al., “Mechanical Properties of the Human Posterior Lens Capsule”, IOVS, vol. 44, No. 2, 2003, pp. 691-696.
  • Krauss, Joel et al., “Laser Interactions With the Cornea”, Survey of Ophthalmology A680, vol. 31, No. 1, Jul./Aug. 1986, pp. 37-53.
  • Kronemyer, Bob, “Accommodating IOL? Impossible, Recent Study Seems to Say”. Ocular Surgery News, http//www.slackmc.com, Sep. 15, 1996, 2 pgs.
  • Krueger, Ronald R. et al., “Experimental Increase in Accommodative Potential after Neodymium: Yttrium—Aluminum—Garnet Laser Photodisruption of Paired Cadaver Lenses”, Ophthalmology, vol. 108, No. 11, 2001, pp. 2122-2129.
  • Krueger, Ronald R. et al., “First safety study of femtosecond laser photodisruption in animal lenses: Tissue morphology and cataractogenesis”, J Cataract Refract Surg, vol. 31, Dec. 2005, pp. 2386-2394.
  • Krueger, Ronald R., M.D., et al., “Nonmechanical Microkeratomes Using Laser and Water Jet Technology”, Publisher unknown, date unknown but prior to Jul. 2009, pp. 1-33.
  • Krueger, R.R., “Surf's Up—Catch a wave with a waterjet”, Jrn. Ref. Surg., vol. 14, No. 3, May/Jun. 1998, pp. 280-281.
  • Krueger, Ronald R., M.D. et al., “Ultrastructure of Picosecond Laser Intrastromal Photodisruption”, Journal of Retractive Surgery, vol. 12, Jul./Aug. 1996, pp. 607-612.
  • Kuizenga, Dirk J., “FM-Laser Operation of the Nd:YAG Laser”, IEEE Journal of Quantum Electronics, vol. 6, No. 11, 1970, pp. 673-677.
  • Kurapkiené, S. et al., “The relationship of ultrasonic and mechanical properties of human nuclear cataract. A pilot study”, Ultragarsas, vol. 54, No. 1, 2005, pp. 39-43.
  • Kurtz, Ron et al., “Femtosecond Laser Corneal Refractive Surgery”, Proc. of SPIE, vol. 3591, 1999, pp. 209-219.
  • Kurtz, Ron et al., “Ophthalmic Applications of Femtosecond Lasers”, Proc. f SPIE, vol. 3616, 1999, pp. 51-65.
  • Kurtz, Ron M. et al., “Optimal Laser Parameters for Intrastromal Corneal Surgery”, Proc. of SPIE, vol. 3255, 1998, pp. 56-66.
  • Kurtz, Ron M., MD, et al., “Photo-disruption in the Human Cornea as a Function of Laser Pulse Width”, Journal of Refractive Surgery, vol. 13, Nov./Dec. 1997, pp. 653-658.
  • Kuszak, J. R. et al., “A Quantitative Analysis of Sutural Contributions to Variability in Back Vertex Distance and Transmittance in Rabbit Lenses as a Function of Development, Growth, and Age”, Optometry and Vision Science, vol. 79, No. 3, Mar. 2002, pp. 193-204.
  • Kuszak, J. R. et al., “Anatomy of Aged and Senile Cataractous Lenses”, from “Biochemistry of the Crystalline Lens”, undated but prior to Jul. 2009, pp. 564-575.
  • Kuszak, J. R. et al., “Biochemistry of the Crystalline Lens; Anatomy of Aged and Senile Cataractous Lenses”, pp. 564-575.
  • Kuszak, J. R. et al., “Development of lens sutures”, Int. J. Dev. Biol., vol. 48, 2004, pp. 889-902.
  • Kuszak, J. R. et al., “Electron Microscope Observations of the Crystalline Lens”, Microscopy Research and Technique, 1996, vol. 33, pp. 441-479.
  • Kuszak, J. R. et al., “Fibre cell organization in crystalline lenses”, Experimental Eye Research, vol. 78, 2004, pp. 673-687.
  • Kuszak, J. et al., “Gap Junctions of Chick Lens Fiber Cells”, Exp. Eye Res., vol. 27, 1978, pp. 495-498.
  • Kuszak, J. R. et al., “Lens Optical Quality and Lens Sutures”, Investigative Ophthalmology & Visual Science, vol. 32, No. 7, Jun. 1991, pp. 2123-2129.
  • Kuszak, J. R. et al., “Lens Optical Quality is a Direct Function of Lens Sutural Architecture”, Investigative Ophthalmology & Visual Science, vol. 32, No. 7, Jun. 1991, pp. 2119-2129.
  • Kuszak, J. R. et al., “Quantitative Analysis of Animal Model Lens Anatomy: Accommodative Range is Related to Fiber Structure and Organization”, undated but prior to Jul. 2009, 26 pgs.
  • Kuszak, J. R. et al., “Suppression of Post-Vitrectomy Lens Changes in the Rabbit by Novel Benzopyranyl Esters and Amides”, Exp. Eye Res., vol. 75, 2002, pp. 459-473.
  • Kuszak, JR et al., “The interrelationship of lens anatomy and optical quality II Primate Lenses”, Exp. Eye Res., vol. 59, 1994, pp. 521-535.
  • Kuszak, J. R. et al., “The Relationship Between Rabbit Lens Optical Quality and Sutural Anatomy after Vitrectomy”, Exp. Eye Res., vol. 71, 2000, pp. 267-281.
  • Kuszak Jer R. et al., “The Structure of the Vertebrate Lens”, Chapter 4, undated but prior to Jul. 2009, pp. 71-118.
  • Kuszak, J. et al., “The Surface Morphology of Embryonic and Adult Chick Lens-Fiber Cells”, The American Journal of Anatomy, vol. 159, 1982, pp. 395-410.
  • Kuszak, J. R. et al., “The Use of an Ex Vivo Mechanical Stretching Apparatus to Examine Fiber Ultrastructure During Accommodation”, undated but prior to Jul. 2009, 1 pg.
  • Kuwabara, Toichiro, et al., “Electron Microscopic Study of Galactose-Induced Cataract”, Investigative Ophthalmology, vol. 8, No. 2, Apr. 1969, pp. 133-149.
  • L'Esperance, Jr. “Ophthalmic Lasers Photocoagulation, Photoradiation and Surgery”, 2nd Edition, The C.V. Mosby Company, copyright 1983, pp. 529-538.
  • Lerman, Sidney, et al., “A Method for Detecting 8-Methoxypsoralen in the Ocular Lens”, Science, vol. 197, Sep. 23, 1977, 1287-1288.
  • Lerman, Sidney, et al., “Photosensitization of the lens by 8-meth-oxypsoralen”, Invent. Ophthalmol. Visual Sci., vol. 16, No. 11, Nov. 1977, pp. 1065-1068.
  • Lerman, Sidney, M.D., “Photosensitizing Drugs and Their Possible Role in Enhancing Ocular Toxicity”, Ophthalmology, vol. 93, No. 3, Mar. 1986, pp. 304-318.
  • Lerman, Sidney, et al., “Psoralen-long-wave Ultraviolet Therapy and Human Cataractogenesis”, Invent. Ophthalmol. Visual Sci., vol. 23, No. 6, Dec. 1982, pp. 801-804.
  • Lerman, Sidney, et al., “Spectroscopic Evaluation and Classification of the Normal, Aging, and Cataractous Lens”, Ophthl. Res., vol. 8, 1976, pp. 335-353.
  • Lim, Seung Jeong, M.D. et al., “Analysis of zonular-free zone and lens size in relation to axial length of eye with age”, J Cataract Refract Surg, vol. 24, Mar. 1998, pp. 390-396.
  • Liu, X. et al., “Competition between Ponderomotive abd Thermal Forces in Short-Scale-Length Laser Plasmas”, Physical Review Letters, vol. 69, No. 13, Sep. 28, 1992, pp. 1935-1938.
  • Liu, Xinbing et al., “In vivo plasma-mediated ablation as a function of laser pulse width”, SPIE, vol. 2975, 1997, pp. 282-288.
  • Loerscher, Hanspeter et al., “Noncontact Trephination of the Cornea Using a Pulsed Hydrogen Floride Laser”, American Journal of Ophthalmology, vol. 104, Nov. 1987, pp. 471-475.
  • Loesel, Frieder H. et al., “Laser-Induced Optical Breakdown on Hard and Soft Tissues and Its Dependence on the Pulse Duration: Experiment and Model”, IEEE Journal of Quantum Electronics, vol. 32, No. 10, Oct. 1996, pp. 1717-1722.
  • Lou, Marjorie F., et al., “Protein-Thiol Mixed Disulfides in Human Lens”, published by Academic Press Limited, 1992, pp. 889-896.
  • Lubatschowski, Holger, “Surgical Laser System for the Treatment of Presbyopia”, 7th Biotech in Europe Investor Forum, Switzerland, Oct. 2-3, 2007, 9 pgs.
  • Lutze, Margaret et al., “Lenses of Diabetic Patients “Yellow” at an Accelerated Rate Similar to Older Normals”, Investigative Ophthalmology & Visual Science, vol. 32, No. 1, Jan. 1991, pp. 194-199.
  • Maguen, Ezra, et al., “Excimer Laser Ablation of the Human Lens at 308 nm with a Fiber Delivery System”, J. Cataract Refract Surg., vol. 15, Jul. 1989, pp. 409-414.
  • Manns, Fabrice et al., “Radius of Curvature and Aspericity of the Anterior and Posterior Surface of Human Cadaver Crystalline Lenses”, Experimental Eye Research, 2004, vol. 78, pp. 39-51.
  • Marion, II, John E. et al., “Medical Applications of Ultra-Short Pulse Lasers”, Proc. of SPIE, vol. 3616, 1999, pp. 42-50.
  • Masters, B.R., “Three-dimensional Microscopic Tomographic Imaging of the Cataract in a Human Lens in Vivo”, Optics Express 332, vol. 3, No. 9, Oct. 1998, pp. 332-338.
  • Mathias, R.T. et al., “Physiological Properties of the Normal Lens”, Physiological Reviews, vol. 77, No. 1, Jan. 1997, pp. 21-50.
  • McBrien, N. A et al., “Experimental Myopia in a Diurnal Mammal (Sciurus carolinesis) with No Accommodative Ability”, J. Physiol., vol. 469, 1993, pp. 427-441.
  • McCourt, M. E et al., Refractive State, Depth of Focus, and Accommodation of the Eye of the California ground squirrel (Spermophiliu beecheyi), Vision Res, vol. 24, No. 10, 1984, pp. 1261-1266.
  • McDonald, Marguerita B., et al., “Central Photorefractive Keratectomy for Myopia, The Blind Eye Study”, Arch Ophthalmol, vol. 108, Jun. 1990, pp. 799-808.
  • Michael, Ralph et al., “Refractive Index of Lens Fiber Membranes in Different Parts of the Crystalline Lens”, Proceedings of SPIE, vol. 4611, 2002, pp. 159-164.
  • Moffat, B.A. et al., “Age-Related Changes in Refractive Index Distribution and Power of the Human Lens as Measured by Magnetic Resonance Micro-Imaging in Vitro”, Vision Research, vol. 42, 2002, pp. 1683-1693.
  • Müller, F. et al., “A Comparative Study of Deposition of Thin Films by Laser Induced PVD with Femtosecond and Nanosecond Laser Pulses”, SPIE, vol. 1858, 1993, pp. 464-474.
  • Mutti, Donald O., et al., “A Video Technique for Phakometry of the Human Crystalline Lens”, Investigative Ophthalmology, & Visual Science, vol. 33, No. 5, Apr. 1992, pp. 1771-1781.
  • Myers, Raymond I. et al., “Feasibility of Using Lasers to Retard Cataract Development in the Ocular Lens by Restoring Lens Movement”; undated but prior to Jul. 2009, pp. 1-22.
  • Myers, Raymond I. et al., “Novel Approaches to Correction of Presbyopia With Laser Modification of the Crystalline Lens”, Journal of Refractive Surgery, vol. 14, Mar./Apr. 1998; pp. 136-139.
  • Nanevicz, Tania M., et al., “Excimer Laser Ablation of the Lens”, Arch Ophthamol, vol. 104, Dec. 1986, pp. 1825-1829.
  • Naranjo-Tackman, Ramon et al., “Subepithelial arquate (sic) incisions, using the femtosecond surgical laser, in post-phaco astigmatism: Preliminary visual and refractive results”, a powerpoint presentation shown at ESCRS meeting held in London England in Sep. 2006, 8 pgs.
  • Neev, Joseph, “Ultrashort Pulse Lasers: A New Tool for Biomedical Applications”, SPIE, vol. 3255; pp. 2-7.
  • Nichamin, Louis D., “Treating astigmatism at the time of cataract surgery”, Current Opinion in Ophthalmology, 2003, vol. 14, p. 35-38.
  • Oberheide, Uwe et al., “Therapy Monitoring of Laser Cyclophotocoagulation”, Proceedings of SPIE, vol. 4611, 2002, pp. 48-53.
  • O'Donnell, Colleen B., et al., “Ablation Smoothness as a Function of Excimer Laser Delivery System”, J. Cataract Refract Surg., vol. 22, Jul./Aug. 1996, pp. 682-685.
  • O'Donnell, Colleen B., et al., “Surface Roughness in PMMA is Linearly Related to the Amount of Excimer Laser Ablation”, Journal of Refractive Surgery, vol. 12, Jan./Feb. 1996, pp. 171-174.
  • Oriowo, Olanrewaju Matthew, “A Study of Ultraviolet Radiation Effects on Procine Crystalline Lens and Development of a New Assay Methodology for UV Cataractogenesis Investigation”, A Thesis Presented to the University of Waterloo, 2000, pp. i-xix and 1-218.
  • Ostrin, Lisa A. et al., “Comparisons Between Pharmacologically and Edinger-Westphal-Stimulated Accommodation in Rhesus Monkeys”, Investigative Ophthalmology & Visual Science, 2005, vol. 46, No. 2, pp. 609-617.
  • Ostrin, Lisa A. et al., “Effects of Pirenzepine on Pupil Size and Accommodation in Rhesus Monkeys”, Investigative Ophthalmology & Visual Science, Oct. 2004, vol. 45, No. 10, pp. 3620-3628.
  • Ostrin, Lisa A. et al., “The Effects of Phenylephrine on Pupil Diameter and Accommodation in Rhesus Monkeys”; Investigative Ophthalmology & Visual Science, 2004, vol. 45, No. 1, pp. 215-221.
  • Parel, Jean-Marie et al., “Intraocular Implants for the Surgical Correction of Presbyopia”; In Ophthalmic Technologies X, Proceedings of SPIE, vol. 3908, 2000, pp. 115-122.
  • Patel, C.K. et al., “The Ageing Lens”, Association of Optometrists, City University, London; undated, www.optometry.co.uk; pp. 27-31.
  • Pau, Hans et al., “The increasing sclerosis of the human lens with age and its relevance to accommodation and presbyopia”, Graefe's Arch Clin Exp. Ophthalmol., (1991) vol. 229, pp. 294-296.
  • Payne, Peter A. et al., “Ophthalmic Applications of Laser-Generated Ultrasound”; SPIE, 2000, vol. 3908, pp. 13-22.
  • Peterson, Jennifer A. et al., “Intraocular Pressure Measurement in Cynomolgus Monkeys, Tono-Pen Versus Manometry”, Investigative Ophthalmology & Visual Science, 1996, vol. 37, No. 6, pp. 1197-1199.
  • Prokofeva, G. I et al., “Effects of Low-Intensity Infrared Laser Irradiation on the Eye, (An Experimental Study)”, Vestn. Oftalmol., vol. 112, No. 1, 1996, pp. 31-32, with English Abstract, 5 pgs.
  • Puliafito, Carmen A., M.D. et al., “High-Speed Photography of Excimer Laser Ablatio of the Cornea”, Arch Ophthalmol, vol. 105, Sep. 1987, pp. 1255-1259.
  • Qian, Wen et al., “3 Year Simvastatin Treatment and Lens Nuclear Back Scattering”; J Ophthalmol, vol. 84, 2000, pp. 512-516.
  • Qian, Wen et al., “Universal Opacity Standard for Scheimpflug Photography”, Ophthalmic Res, 2000, vol. 32, pp. 292-298.
  • Rafferty, Nancy et al., “Lens Wound Healing and Cataractogenesis in a Pigmented Eye”, Exp. Eye Res. (1984), vol. 38, pp. 267-277.
  • Riley, Michael V., et al., “The Effects of UV-B Irradiation on the Corneal Endothelium”, Eye Research Institute of Oakland University, 1987, pp. 1021-1033.
  • Ripken, T. et al., “FEM Simulation of the Human Lens Compared to Ex-Vivo Porcine Lens Cutting Pattern: A Possible Treatment of Presbyopia”; undated, 11 pgs.
  • Ripken T. et al., “First in-vivo studies of Presbyopia treatment with ultrashort laser pulses”, Proc. SPIE 5142, vol. 137, 2003, 9 pgs.
  • Ripken, T. et al., “Fs-laser Induced Elasticity Changes to Improve Presbyopic Lens Accommodation”, undated, 10 pgs.
  • Ripken T. et al., “Investigations for the correction of Presbyopia by fs-laser induced cuts”, Proc. SPIE 5314, vol. 27, 2004, 9 pgs.
  • Rockwell, B.A. et al., “Safe Use of Ultra-short Lasers”; SPIE, vol. 3616, 1999, pp. 32-39.
  • Roesner, C.A.D. et al., “Light-Matter Interactions on the FEMTOSECOND Time Scale”, Department of Physics and Division of Engineering and Applied Sciences, Harvard University; undated, pp. 1-27.
  • Rol, Pascal et al., “An Optomechanical Eye Model for Observation of Lens Photoablation”; SPIE, 1997, vol. 2971, pp. 171-174.
  • Sacks, Zachary S. et al., “Laser Spot Size as a Function of Tissue Depth and Laser Wavelength in Human Sclera”, SPIE, 1998, vol. 3255, pp. 67-76.
  • Sauteret, C. et al., “Laser designers eye petawatt power”, Laser Focus World, Oct. 1990, pp. 85-92 with cover page.
  • Scammon, Richard J. et al., “Simulations of Shock Waves and Cavitation Bubbles Produced in Water by Picosecond and Nanosecond Laser Pulses”, SPIE, 1998, vol. 3254, pp. 264-275.
  • Schachar, Ronald A. MD, PhD., et al., “A Revolutionary Variable Focus Lens”, Annals of Ophthalmology, vol. 28, No. 1, Jan./Feb. 1996, pp. 11-18.
  • Schachar, Ronald A., M.D., “Cause and Treatment of Presbyopia With a Method for Increasing the Amplitude of Accommodation”, Annals of Ophthalmol, 1992, vol. 24, pp. 445-452.
  • Schachar, Ronald A., M.D. et al., “Experimental Destruction of Cataractous Lenses by Laser”, Ophthalmic Surgery, Surgical Forum, pp. 506-509.
  • Schachar, Ronald A., M.D. et al., “Experimental Support for Schachar's Hypothesis of Accommodation”, Ann Ophthalmol, 1993; vol. 25, pp. 404-409.
  • Schachar, Ronald A., MD, PhD, “Histology of the Ciliary Muscle-Zonular Connections”, Annals of Ophthalmology, vol. 28, No. 2, Mar./Apr. 1996, pp. 70-79.
  • Schachar, Ronald A. MD et al., “Mechanism of Human Accommodation as Analyzed by Nonlinear Finite Element Analysis”, Ann Ophthalmol; 2001; vol. 33, No. 2, pp. 103-112.
  • Schachar, Ronald A., MD, PhD, “Pathophysiology of Accommodation and Presbyopia, Understanding the Clinical Implications”, J. Florida M.A., vol. 81, No. 4, Apr. 1994, pp. 268-271.
  • Schaeffel, Frank, “Kappa and Hirschberg Ratio Measured With an Automated Video Gaze Tracker”, Optometry and Vision Science, 2002, vol. 79, No. 5, pp. 329-334.
  • Schaffer, Chris B. et al., “Dynamics of Femtosecond Laser-Induced Breakdown in Water From Femtoseconds to Microseconds”, Optics Express, 2002, vol. 10, No. 3, pp. 196-203.
  • Schaffer, Chris B. et al., “Morphology of Femtosecond Laser-Induced Structural Changes in Bulk Transparent Materials”, Applied Physics Letters, vol. 84, No. 9, 2004, pp. 1441-1443.
  • Shen, Nan, et al., “Ablation of Cytoskeletal Filaments and Mitochondria in Live Cells Using a Femtosecond Laser Nanoscissor”, MCB, 2005, vol. 2, No. 1, pp. 17-25.
  • Shen, Nan; “Photodisruption in Biological Tissues Using Femtosecond Laser Pulses”, A Thesis Presented to the Department of Physics, Harvard University, 2003, pp. 1-125.
  • Shen, Nan, et al., “Photodisruption in Biological Tissues and Single Cells Using Femtosecond Laser Pulses”, undated, 2 pgs.
  • Shen, Nan, et al., “Surface and Bulk Photodisruption in Turbid Tissue Using Femtosecond Laser Pulses”, Department of Physics and Division of Engineering and Applied Sciences, Harvard University, undated, pp. 1-24.
  • Sher, Neal A., MD, “Hyperopic Refractive Surgery”, Current Opinion in Ophthalmology, 2001, vol. 12, pp. 304-308.
  • Sivak, Jacob G., “Through the Lens Clearly: Phylogeny and Development, The Proctor Lecture”, Ophthalmology & Visual Science, 2004, vol. 45, No. 3, pp. 740-747.
  • Sliney, D. H et al., “Medical Lasers and Their Safe Use”, Springer Verlag, New York, 1993, pp. 42-50.
  • Slingsby, Christine, “Lens Crystallin Crystal Structures”, undated article, 3 pgs.
  • Söderberg, Per G., et al., “Angular Dependence of the Intensity of Back Scattered Light From Human Lenses With Nuclear Cataract, Implications for Measurement”, SPIE, 2000, vol. 3908, pp. 34-37.
  • Söderberg, Per G., et al., “External Standard for Measurements with the Scheimpflug Slitlamp Microscope”, SPIE, 1997, vol. 2971, pp. 8-13.
  • Soileau, M. J. et al., “Temporal Dependence of laser-Induced Breakdown in NaCl and Si02”, prepared for Dept. of Physics, North Texas State University, publication date unknown, 19 pgs.
  • Solomon, Ira Seth, M.D., “Aqueous Humor Dynamics”, undated, 17 pgs.
  • Spector, Abraham, “Aging of the Lens and Cataract Formation”, Aging and Human Visual Function, pp. 27-43.
  • Srinivasan, R., “Ablation of Polymers and Biological Tissue by Ultraviolet Lasers”, Oct. 1986, pp. 932-935.
  • Srinivasan R. et al., “Excimer Laser Surgery of the Cornea”, American Journal of Ophthalmology, vol. 96, 1993, pp. 710-715.
  • Stitzel, Joel D., et al., “A Nonlinear Finite Element Model of the Eye With Experimental Validation for the Prediction of Globe Rupture”, Stapp Car Crash Journal, 2002, vol. 45, 24 pgs.
  • Stitzel, Joel D., et al., “Blunt Trauma of the Aging Eye”, Arch Ophthalmol, 2005, vol. 123, pp. 789-794.
  • Strauss, Moshe, et al., “Two-Dimensional Rayleigh Model of Vapor Bubble Evolution”, SPIE, 1999, vol. 3601, pp. 212-224.
  • Strenk, Susan A., et al, “Age-Related Changes in Human Ciliary Muscle and Lens: A Magnetic Resonance Imaging Study”, Investigative Ophthalmology & Visual Science, 1999, vol. 40, No. 6, pp. 1162-1169.
  • Strenk, Susan A. et al., “Magnetic Resonance Imaging Study of the Effects of Age and Accommodation on the Human Lens Cross-Sectional Area”, IOVS, 2004, Vo. 45, No. 2, pp. 539-545.
  • Strenk, Susan A., et al, “The Mechanism of Presbyopia”, Progress in Retinal and Eye Research, 2004 vol. 11, pp. 1-15.
  • Stuart, B. C. et al., “Laser-Induced Damage in Dielectrics with Nanosecond to Subpicosecond Pulses”, Physical Review Letters, vol. 74, No. 12, Mar. 20, 1995, pp. 2248-2251.
  • Sweeney, Matthew H.J., et al., “Movement of Cysteine in Intact Monkey Lenses: The Major Site of Entry is the Germinative Region”, Experimental Eye Research, 2003, vol. 77. pp. 245-251.
  • Swegmark, Gunnar, “Studies With Impedance Cyclography on Human Ocular Accommodation At Different Ages”, ACTA Ophthalmologica, vol. 47, 1969, pp. 1186-1206.
  • Taboada, J., et al., “Optically Coupled Technique for Photorefractive Surgery of the Cornea”, Optics Letters, vol. 15, No. 9, May 1, 1990, pp. 458-460.
  • Taboada, J. et al., “Response of the Corneal Epithelium to KrF Excimer Laser Pulses”, Health Physics, vol. 30, 1981, pp. 677-683.
  • Tahi, Hassan, et al., “Restoring Accommodation: Surgical Technique and Preliminary Evaluation in Rabbits”, SPIE, 1999, vol. 3591, pp. 267-269.
  • Tamm, Svenja, et al., “Age-Related Changes of the Human Ciliary Muscle. A Quantitative Morphometric Study”, Mechanisms of Aging and Development, vol. 62, 1992, pp. 209-221.
  • Tang, Daxin; “Influence of Age, Diabetes, and Cataract on Calcium, Lipid-Calcium, and Protein-Calcium Relationships in Human Lenses”, Investigative Ophthalmology & Visual Science, 2003, vol. 44, No. 5, pp. 2059-2066.
  • Taylor, Virginia L. et al., “Morphology of the Normal Human Lens”, Investigative Ophthalmology & Visual Science, Jun. 1996, vol. 37, No. 7, pp. 1396-1410.
  • Topilow, Harvey W., M.D., “Vitreous Changes in Retinal Branch Vein Occlusion”, Arch Ophthalmol, vol. 105, Sep. 1987, 2 pgs.
  • Trokel, Stephen L., M.D., et al., “Excimer Laser Surgery of the Cornea”, American Journal of Ophthalmology, vol. 96, No. 6, Dec. 1983, pp. 710-715.
  • Tsai, Philbert S., “All-Optical, In-Situ Histology of Neuronal Tissue with Femtosecond Laser Pulses”, Imaging in Neuroscience and Development, CSHL Press, undated, 12 pgs.
  • Tsubota, Kazuo, “Application of Erbium: YAG Laser in Ocular Ablation”, Ophthalmologica, 1990, vol. 200, pp. 117-122.
  • Van Alphen, G.W.H.M. et al., “Elasticity of Tissues Involved in Accommodation”, Vision Res., vol. 31, No. 7/8, 1991, pp. 1417-1438.
  • Venugopalan, V. et al., “The Thermodynamic Response of Soft Biological Tissues to Ultraviolet Laser Irradiation”, Biophysical Journal, vol. 60, Oct. 1995, pp. 1258-1271.
  • Vilupuru, Abhiram S., “Optical and Biometric Relationships of the Isolated Pig Crystalline Lens”, Ophthal. Physiol. Opt., 2001, vol. 21, No. 4, pp. 296-311.
  • Vilupuru, Abhiram S., “Spatially Variant Changes in Lens Power During Ocular Accommodation in a Rhesus Monkey Eye”, Journal of Vision, 2004, vol. 4, pp. 299-309.
  • Vogel, Alfred et al., “Factors Determining the Refractive Effects of Intrastromal Photorefractive Keratectomy with the Picosecond Laser”, J. Cataract Refract Surg., vol. 23, Nov. 1997, pp. 1301-1310.
  • Vogel, Alfred et al., “Interaction of Laser-Produced Cavitation Bubbles With an Elastic Tissue Model”, SPIE, 2001, vol. 4257, pp. 167-177.
  • Vogel, Alfred et al., “Intraocular Photodisruption With Picosecond and Nanosecond laser Pulses: Tissue Effects in Cornea, Lens and Retina”, Investigative Ophthalmology & Visual Science, Jun. 1994, No. 7, vol. 35, pp. 3032-3044.
  • Vogel, Alfred et al., “Kinetics of Phase Transitions in Pulsed IR Laser Ablation of Biological Tissues”, SPIE, 2003, vol. 4961, pp. 66-74.
  • Vogel, Alfred et al., “Laser-Induced Breakdown in the Eye At Pulse Durations From 80 ns to 100 fs”, SPIE, 1998, vol. 3255, pp. 34-49.
  • Vogel, Alfred et al., “Numerical Simulation of Optical Breakdown for Cellular Surgery At Nanosecond to Femtosecond Time Scales”, SPIE, 2001, vol. 4433, pp. 70-80.
  • Vrensen, G. F. J. M., “Aging of the human eye lens—a morphological point of view”, Comp. Biochem. Physiol., vol. 111A, 1995. pp. 519-553.
  • Waring III, George O., M.D., “Presbyopia and Accommodative Intraocular Lenses—the Next Frontier in Refractive Surgery?”, Refractive & Corneal Surgery, vol. 8, Nov./Dec. 1992, pp. 421-423.
  • Weale, Robert D., SC., “Presbyopia Toward the End of the 20th Century”, Survey of Ophthalmology, vol. 34, No. 1, Jul.-Aug. 1989, pp. 15-29.
  • Werblin, Theodore P., M.D., “Should We Consider Clear Lens Extraction for Routine Refractive Surgery?”, Refractive & Corneal Surgery, vol. 8, Nov./Dec. 1992, pp. 480-481.
  • Werner, Liliana, MD, et al., “Capsular Bag Opacification After Experimental Implantation of a New Accommodating Intraocular Lens in Rabbit Eyes”, J Cataract Refract Surg., 2004, vol. 30, pp. 1114-1123.
  • Werner, Liliana, MD. et al., “Posterior Capsule Opacification in Rabbit Eyes Implanted With 1-Piece and 3-Piece Hydrophobic Acrylic Intraocular Lenses”, J Cataract Refract Surg, 2005, vol. 31, pp. 805-811.
  • Wilks, S. C. et al., “Absorption of ultra-Intense Laser Pulses”, Physical Review Letters, vol. 69, No. 9, Aug. 31, 1992, pp. 1383-1386.
  • Wyatt, Harry J., “Application of a Simple Mechanical Model of Accommodation to the Aging Eye”, Eye Res., vol. 33, No. 5/6, 1993, pp. 731-738.
  • Ziebarth, Nöel, et al; “Non-contact Optical Measurement of Lens Capsule Thickness During Simulated Accommodation”, SPIE, 2005, vol. 5688, pp. 19-25.
  • Zuclich, Joseph A. et al., “A comparison of laser-induced retinal damage from infrared wavelengths to that from visible wavelengths”, Lasers and Light, vol. 8, No. 1, 1997, pp. 15-29.
  • Zuclich, Joseph A. et al., “In Situ Measurements of Lens Fluorescence and its Interference With Visual Function”, Investigative Ophthalmology & Visual Science, vol. 33, No. 2, 1993, pp. 410-415.
  • Zuclich, Joseph, “In Vivo Measurements of Optical Properties of the Ocular Lens”, Reprinted from Proceedings of Ultraviolet Radiation Hazards, Jan. 26-27, 1994, SPIE—The International Society for Optical Engineering, Vo. 2134B Ultraviolet Radiation Hazards, 1994, pp. 99-112.
  • Zuclich, J.A., et al., “Ocular Effects of Penetrating IR Laser Wavelengths”, Reprinted from Proceedings of Laser-Tissue Interaction VI, Feb. 6-9, 1995, SPIE—The International Society for Optical Engineering, vol. 2391, 1995, pp. 111-125.
  • Zuclich, Joseph A., et al., “Rapid Noninvasive Optical Characterization of the Human Lens”, Lasers in the Life Sciences, 6(1), 1994, pp. 39-53.
  • Zuclich, Joseph A., “Research on the Ocular Effects of Laser Radiation”, Published by Technology Incorporated: Life Sciences Division, publication date unknown, 59 pgs.
  • Zuclich, Joseph A., “Ultraviolet-Induced Photochemical Damage in Ocular Tissues”, Health Physics, vol. 56, No. 5, May 1989, pp. 671-681.
  • Zuclich, Joseph A., “Workshop on Long-Term Visual Health Risks of Optical Radiation—Thermal Cataracts Induced by UV Laser Radiation”, Workshop Report, Cataract Working Group, publisher unknown, publication date unknown, 13 pgs.
  • Agrahari, S. et al., “The Potential of Photodisruption Laser Treatment of the Crystalline Lens to Rupture the Lens Capsule”, ARVO Abstract No. 07-A-6800, 2006, 1 pg.
  • Faraggi, E. et al., “Stress confinement, shock wave formation and laser induced damage”, Conference 5695: Optical Interactions with Tissue and Cells XVI, Photonics West, undated, 1 pg.
  • Fisher, R F, “The ciliary body in accommodation”, Trans Ophthalmol. Soc. UK, 1989, vol. 105,1 pg.
  • Fisher, RF. “The mechanics of accommodation in relation to presbyopia”, Eye, 1988, vol. 2, 1 pg.
  • Frey, R. W. et al., “Modification of Lens Mechanics of Human Cadaver and Porcine Lenses Using Photodisruption Laser to Change Lens Power and Increase Flexibility”, ARVO Abstract No. 07-A-06652, 2006, 1 pg.
  • Garner, LF et al., “Changes in equivalent and gradient refractive index of the crystalline lens with accommodation”, Optom Vis. Sci., 1997, vol. 74,1 pg.
  • Garner LF et al., “Changes in ocular dimensions and refraction with accommodation”, Ophthalmic Physiol. Opt., 1997, vol. 17, 1 pg.
  • Gray, G. et al., “Constructions of a Computer Mesh Model of the Anatomical Human Crystalline Lens Fiber Ultrastructure”, ARVO Abstract, 2006, 1 pg.
  • Helsterkamp, A. et al., “Nanosurgery in live cells using ultrashort laser pulses”, Conference 5695: Optical Interactions with Tissue and Cells XVI, Photonics West, undated, 1 pg.
  • Kuszak, J.R., “Progressively More Complex Star Sutures Formed in Primate Lenses During Periods of Development, Growth and Aging Are Related to Accommodation”, Abstracts Online, obtained from the Internet on Apr. 19, 2006 at: http://www.abstractsonline.com/viewer/viewAbstractPrintFriendly.asp?CKey={C8FDF5D...4/19/06, I page.
  • Kuszak, J. R. et al., “Results From a Finite Element Model Analysis of the Accommodative Process Based on the Human Crystalline Lens Fiber Ultrastructure”, ARVO Abstract, 2006, 1 pg.
  • McBrien NA et al., “Experimental myopia in a diurnal mammal (Sciurus carolinensis) with no accommodative ability”, J Physiol., 1993, vol. 469, 1 pg.
  • McCourt ME et al., “Refractive state, depth of focus and accommodation of the eye of the California ground squirrel (Spermophilus beecheyi)”, Vision Res., 1984, vol. 24, 1 pg.
  • Oberheide, U. et al., “Flexibility Increase of Human Donor Lenses After Femosecond Laser Treatment (fs-Lentotomy)”, ARVO Abstract No. 3833/B571, 2007, 2 pgs.
  • Olmstead, T. et al., “The Use of an Off Axis Slit Laser Camera System for Determining Photodisruptive Laser Placement in Lenses”, ARVO Abstract No. 07-A-5967, 2006, 1 pg.
  • Rafferty, NS et al., “Comparative study of actin filament patterns in lens epithelial cells, Are these determined by the mechanisms of lens accommodation?”, Curr Eye Res., 1989, vol. 8, 1 pg.
  • Roa, Ch. Mohan et al., “Level of Reduced Nucleotides and Lens Photodamage”, National Eye Institute, undated, 1 pg.
  • Subramaniam, H. et al., “Finite Element Analysis of the Accommodative Process in the Whole Globe”, ARVO Abstract No. 07-A-6249, 2006, 1 pg.
  • Van Alphen GW et al., “Elasticity of tissues involved in accommodation”, Vision Res., 1991, vol. 31, 1 pg.
  • Wang, B. et al., “In-vivo animal studies on intraocular nanosurgery with low-energy 80 MHZ near infrared femtosecond laser pulses”, Conference 5695: Optical Interactions with Tissue and Cells XVI, Photonics West, undated, 1 pg.
  • Yeilding, R. H. et al., “Lens Culture System for Long Term Study of Porcine Lenses Pre and Post Laser Photodisruption Treatment”, ARVO Abstract No. 01-A-6495, 2006, 1 pg.
  • Zepkin, N. et al., “Measurement of Temperature Rise in Porcine Crystalline Lenses from a Photodisruption Laser”, ARVO Abstract No. 07-A-6709, 2006, 1 pg.
  • Zoltoski, R. K. et al., “Reverse Engineering of Human Lenses”, ARVO Abstract No. 2018/B159, 2007, 2 pgs.
  • AVRO, “Statement for the Use of Animals in Ophthalmic and Visual Research”, The Association for Research in Vision and Ophthalmology, copyright © 2002, obtained from the Internet on Jan. 15, 2005 at: http://www.avro.org/AboutAvro/animalst.asp, 3 pgs.
  • Gattass, Rafael et al., “Femtosecond laser micromaching Applications in Technology and Biology”, Photonics West conference Jan. 2005, 78 pgs.
  • Hermans, E. et al., “Estimating the External Force Acting on the Human Eye Lens During Accommodation Using Finite Elements Modeling”, presentation on Accommodation & Presbyopia, May 2005, 1 pg.
  • Kuszak et al., “Light, scanning and electron micrographs have lead to the following interpretations of secondary fiber formation”, 2004, 16 pgs.
  • Lubatschowski, H. et al., “Treatment of Presbyopia by Cutting the Cystaline Lens: A Comparison of FEM Simulation and Ex vivo Studies”, Lazer Zentrum Hannover e.V., Publication date unknown, 22 pgs.
  • Mazur, Eric, “An Introduction to Femtosecond Laser Science”, Photonics West conference Jan. 2005, 291 pgs.
  • Nebel, Achim et al., “Fast Micromachining using Picosecond Lasers”, Photonics West conference Jan. 2005, 37 pgs.
  • OSN SuperSite, “Increase in lens stiffness with age may cause presbyopia, study suggests”, 2005, 1 pg.
  • “Presbyopia—preconditions”, Laser Zentrum Hannover, undated, 11 pgs.
  • “Principles of Ultrafast Laser Surgery Femtosecond Laser—Tissue Interaction”, copyright © Center for Ultrafast Optical Sciences, Un. of Michigan, undated, 3 pgs.
  • Roundy, Carlos—“Propagation factor qualifies leaser bean performance”, Laser World Focus, undated, 3 pgs.
  • Shen, J. et al. “Measurement of the Lens Capsule Contraction Force in the Radial Direction”, presentation on Accommodation & Presbyopia, May 2005, 1 pg.
  • Figure 4.2—Optical constants for a “standard eye”, publication unknown, undated, 1 pg.
  • Picture of an eye obtained from the Internet on Mar. 28, 2005 at: http://www.opt.uh.edu/research/aglasser/aao/gonioani.gif, 1 pg.
  • Pictures of eyes, date and publisher unknown, 5 pgs.
  • Loesel paper graphs, date and publisher unknown, 2 pgs.
  • U.S. Appl. No. 14/142,255, filed Dec. 27, 2013, Naranjo-Tackman et al.
  • Unpublished U.S. Appl. No. 14/142,255, filed Dec. 27, 2013, 25 pgs.
  • Chinese Search Report from related application No. CN 201080042778.9, dated Nov. 27, 2013, 9 pgs (English translation of Search Report attached).
  • European Search Report from related application No. EP 10 802 654.3, dated Nov. 13, 2013, 4pgs.
Patent History
Patent number: 8758332
Type: Grant
Filed: Jul 7, 2010
Date of Patent: Jun 24, 2014
Patent Publication Number: 20110160710
Assignee: LensAR, Inc. (Orlando, FL)
Inventors: Rudolph W. Frey (Maitland, FL), Ramón Naranjo-Tackman (Mexico City)
Primary Examiner: Dawayne A Pinkney
Application Number: 12/831,783
Classifications
Current U.S. Class: Cataracts Or Glaucoma (606/6); Ophthalmic (606/4); Light Application (607/88); Methods (128/898)
International Classification: A61B 18/18 (20060101); A61N 5/06 (20060101); A61B 19/00 (20060101);